Postanoxic Action Myoclonus (Lance-Adams Syndrome) Responding to Valproate

Rollinson, Russell D.; Gilligan, Bernard S.

doi:10.1001/archneur.1979.00500370074019

Cited by 40 publications

(10 citation statements)

References 11 publications

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“…Standard anticonvulsants such as phenytoin and phenobarbital have not been found useful. [3] Favorable response has been reported with clonazepam, valproic acid,[4] piracetam[5] and levetiracetam,[6] zonisamide and lacosamide. [7] However, very high doses of piracetam (20-45 g/day) or levetiracetam (3000-3500 mg/day) are required in the treatment of myoclonus which is not very practical.…”

Section: Discussionmentioning

confidence: 99%

Volatile anesthetic for the control of posthypoxic refractory myoclonic status

Rayadurg

Radhakrishnan

Rao

2016

Indian Journal of Critical Care Medicine

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Posthypoxic myoclonus (Lance–Adams syndrome) is characterized by myoclonus involving multiple muscle groups which is resistant to most conventional antiepileptic drugs. We present a case of hypoxic brain injury-induced myoclonic status epilepticus successfully controlled with isoflurane. The antimyoclonic effects of isoflurane are likely due to potentiation of inhibitory postsynaptic GABAA receptor–mediated currents and its effects on thalamocortical pathways. It is effective even when intravenous agents fail to control myoclonus. It may be a useful alternative to intravenous anesthetics as a third tier therapy in patients with refractory status myoclonus.

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Section: Discussionmentioning

confidence: 99%

Volatile anesthetic for the control of posthypoxic refractory myoclonic status

Rayadurg

Radhakrishnan

Rao

2016

Indian Journal of Critical Care Medicine

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“…Several treatment options have been previously proposed, however, the results are inconsistent. Drugs that augment GABA-ergic transmission are useful in all types of myoclonus, and CZP and VPA are the first-line treatments 13,14 . Approximately 50% of patients respond to treatment, although often partially 5 .…”

Section: Discussionmentioning

confidence: 99%

Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

et al. 2014

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Introduction.Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

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“…In the first place, there is biochemical evidence that GABAergic neu rons are differentially affected by hypoxia in the spinal cord [2]. One of the long-term sequelae of hypoxia is the occasional devel opment of epileptic or subepileptic pheno mena [5][6][7][8] which could reflect the loss of tonic inhibitory influences in the nervous sys tem. Finally, it has been observed that when mature rats are placed in a 100";, nitrogen atmosphere, seizures usually ensue.…”

Section: Discussionmentioning

confidence: 99%

Age-Related Differences in the in vitro Rat Hippocampus

Dunwiddie¹

1981

Dev Neurosci

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The effects of hypoxia were studied in hippocampal slices prepared from animals of 10–120 days of age. Excitatory synaptic responses could be evoked at all ages, while inhibitory responses began to appear 14–17 days postpartum; both types of responses became maximal at approximately 30 days of age. Inhibitory responses were somewhat more susceptible to the deleterious effects of hypoxia than were excitatory ones. Very young animals showed virtually no effects of hypoxia. However, past 30 days of age, all types of synaptic responses became progressively more sensitive to the effects of hypoxia.

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Postanoxic Action Myoclonus (Lance-Adams Syndrome) Responding to Valproate

Cited by 40 publications

References 11 publications

Volatile anesthetic for the control of posthypoxic refractory myoclonic status

Volatile anesthetic for the control of posthypoxic refractory myoclonic status

Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

Age-Related Differences in the in vitro Rat Hippocampus

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