Myoclonus-like involuntary movements following cesarean delivery epidural anesthesia

Kang, Hyungsook; Lee, Sang Wook; Hong, Eun Pyo; Sim, Yeo Hae; Lee, Su-Mi; Park, Sung Wook; Kang, Jong-Man

doi:10.1016/j.jclinane.2016.05.014

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…Segmental SM typically originates within a few or several adjacent spinal segments of the spinal cord, whereas propriospinal myoclonus refers to myoclonic involuntary movements that involve muscles innervated by many different segments [1,10]. In our patient, SM was initially mild and subsequently evolved to severe movements.…”

Section: Discussionmentioning

confidence: 90%

“…In this patient, midazolam was administrated during surgery. Some reports have suggested that the antiepileptic drug benzodiazepines may be useful in treating patients with SM-NA [10,11]; however, a preceding administration of midazolam may contribute to few prophylactic effects for SM-NA. SM-NA sometimes presents in a severe form, which can cause unexpected perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

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A case of spinal myoclonus in a patient with elective cesarean section

Shiratori¹,

Hotta

Satoh

et al. 2018

JA Clin Rep

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Background: Transient myoclonic involuntary movements, typically referred to as spinal myoclonus (SM), rarely develop in the extremities following neuraxial anesthesia (NA). NA indications in patients with history of SM following NA (SM-NA) are unknown. Case presentation: A 33-year-old woman developed SM-NA after elective cesarean section (CS). Approximately 130 min after spinal anesthesia induction, she began exhibiting involuntary movements, which became most severe after approximately 3 h. The involuntary movements gradually decreased without treatments and disappeared after approximately 5 h. The patient underwent CS on three occasions. The first CS (age, 29 years) was under a combination of spinal and epidural anesthesia. The third CS (age, 35 years) was completed using only spinal anesthesia. There were no neurological events during the postoperative courses for the first and third CS. Conclusions: SM-NA can unexpectedly occur, and history of SM-NA may not be contraindicative for repeated NA.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A case of spinal myoclonus in a patient with elective cesarean section

Shiratori¹,

Hotta

Satoh

et al. 2018

JA Clin Rep

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show abstract

“…8 Although rare, there have also been reports of myoclonus after neuraxial spinal anesthesia, combined spinal epidural anesthesia for cesarean delivery, and epidural anesthesia/analgesia. [3][4][5][6] Menezes and Venkat 5 reported the development of spinal myoclonus after combined spinal epidural anesthesia for cesarean delivery. Bilateral twitching of mainly the lower limbs developed a week after delivery.…”

Section: Case Reportmentioning

confidence: 99%

“…10 Intravenous midazolam has also been used with partial success for spinal myoclonus following epidural anesthesia. 4 Interestingly, a repeat dose of regional anesthesia with bupivacaine has been reported to successfully abort myoclonus after spinal anesthesia. 11 It was hypothesized by the authors that this was a result of correcting the disinhibition of spinal cord hyperactivity.…”

Section: Case Reportmentioning

confidence: 99%

“…2 Neuraxial administration of drugs such as local anesthetics and opioids can also rarely cause spinal myoclonus. [3][4][5][6] Lumbar transforaminal epidural injections of steroids and local anesthetic are commonly performed pain procedures to reduce lumbar radicular pain. We present a case of myoclonus developing during transforaminal epidural steroid and local anesthetic injection.…”

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confidence: 99%

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