Improvement of Post-hypoxic Myoclonus with Bilateral Pallidal Deep Brain Stimulation: A Case Report and Review of the Literature

Myoclonus and other jerky movement disorders

“…Deep brain stimulation surgery has been gaining increasing study, but it is not known whether it is a reliable therapy. Several stimulation sites have been attempted including thalamus, globus pallidus, subthalamic nucleus, and substantia nigra pars reticulata ( di Giacopo et al, 2019 , Kobayashi et al, 2010 , Ramdhani et al, 2017 ).…”

Pallidal Deep Brain Stimulation for Refractory Celiac-Related Myoclonus

“…Although most neurological symptoms may improve or stabilize with a gluten-free diet, myoclonus is less responsive [ 2 ]; thus, an effective treatment for CD-related myoclonus is needed. Given the notion that deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) can improve conditions such as myoclonus-dystonia (MD) or post-hypoxic myoclonus (PHM) [ 3 , 4 ], GPi DBS might be a treatment option for CD-related myoclonus. Herein, we report the case of a patient with CD-related myoclonus ataxia who showed partial benefit from GPi DBS.…”

“…Based on the different responses to GPi DBS, pallidal stimulation could be effective mainly for subcortical myoclonus, although its effect on cortical myoclonus is still unclear. GPi DBS is also effective for refractory myoclonus in PHM, although the mechanism of pallidal stimulation in PHM is still poorly understood [ 3 , 7 ]. The myoclonus in PHM is known as mainly cortical myoclonus, but patients with PHM might often present both types of myoclonus [ 3 ].…”

“…GPi DBS is also effective for refractory myoclonus in PHM, although the mechanism of pallidal stimulation in PHM is still poorly understood [ 3 , 7 ]. The myoclonus in PHM is known as mainly cortical myoclonus, but patients with PHM might often present both types of myoclonus [ 3 ]. Unlike MD and PHM, myoclonus in CD originates from the cortex, as electrophysiologically confirmed in our patient [ 5 ].…”