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Adult-Onset Myoclonus in a Large Urban Inpatient Setting: A Retrospective Cohort Study
Karin Oh1, Moath Hamed2,3, Donna Zarandi4
1Department of Neurology, Columbia University Irving Medical Center, New York, NY, US.
Tremor and Other Hyperkinetic Movements (New York, N.Y.)
|January 13, 2025
Summary
Adult-onset myoclonus is often underdiagnosed in hospitals. Hypoxic-ischemic causes are common, resistant to treatment, and linked to higher mortality, while neurodegenerative and idiopathic cases have better outcomes.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Myoclonus is a hyperkinetic movement disorder with diverse causes, presentations, and treatment responses.
- Adult-onset myoclonus in inpatient settings is understudied.
Purpose of the Study:
- To investigate the demographics, etiologies, and outcomes of adult-onset myoclonus in an inpatient population.
- To identify factors associated with treatment resistance and mortality.
Main Methods:
- Retrospective chart review of adult inpatients diagnosed with myoclonus.
- Data collection from 2011-2021 at a single urban hospital.
- Descriptive statistical analysis to determine etiology-specific characteristics and outcomes.
Main Results:
- 279 patients were analyzed; over 50% were initially misdiagnosed.
- Toxic-metabolic and hypoxic-ischemic etiologies were most frequent.
- Hypoxic-ischemic myoclonus showed poor treatment response and high in-hospital mortality.
- Treatment efficacy decreased with sequential anti-seizure drug trials.
Conclusions:
- Adult-onset myoclonus is frequently underdiagnosed and presents with varied etiologies and outcomes.
- Hypoxic-ischemic causes represent a significant challenge due to resistance and mortality.
- Further research is needed to improve diagnosis and management strategies.
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