Treatment of Post-Hypoxic Myoclonus
Post-hypoxic myoclonus usually presents as multifocal myoclonus following a hypoxic episode. Typically, it is worse with action, has both positive and negative myoclonus, and leads to significant disability. Clinical neurophysiological studies can be helpful if the diagnosis is in doubt. Treatment with specific anticonvulsants can be helpful, but negative myoclonus is particularly refractory.
KeywordsHypoxia Anoxia Myoclonus Epilepsy
At rest, there are myoclonic jerks in the left upper limb which exacerbate during maintenance of posture and especially during movement at which point they are mostly proximal and of large amplitude. The myoclonus, predominantly of the left upper limb, also exacerbates while squeezing the examiner’s fingers. There are myoclonic jerks in the lower limbs that also worsen with movement. When attempting to push back in the wheelchair, the myoclonus increases, particularly in the proximal upper limbs (WMV 60045 kb)