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Post-hypoxic Myoclonus: Current Concepts, Neurophysiology, and Treatment
Harsh V Gupta1, John N Caviness1
1Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
Tremor and Other Hyperkinetic Movements (New York, N.Y.)
|October 7, 2016
Summary
Post-hypoxic myoclonus can present as acute or chronic syndromes, differing from classic Lance-Adams syndrome. Understanding these distinct neurophysiological features is crucial for effective management.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Myoclonus frequently occurs after hypoxic events.
- Classic Lance-Adams syndrome (LAS) describes persistent post-hypoxic myoclonus.
- Acute myoclonus post-hypoxia may present differently than LAS.
Approach:
- A comprehensive literature review was conducted from 1960 to 2015.
- PubMed database was searched using terms related to post-hypoxic myoclonus and LAS.
- Included articles focused on clinical features, neurophysiology, management, and prognosis.
Key Points:
- Two distinct syndromes identified: acute (within hours of hypoxia, generalized, in coma) and chronic (with mental recovery, multifocal cortical action myoclonus).
- Both syndromes share some neurophysiological findings but also exhibit unique characteristics.
- Treatment strategies differ significantly between acute and chronic post-hypoxic myoclonus.
Conclusions:
- Post-hypoxic myoclonus encompasses distinct acute and/or chronic syndromes.
- Potential mechanisms involve cortical and/or subcortical structures.
- Further research is necessary to elucidate mechanisms and optimize treatments for post-hypoxic myoclonus.
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