Post-hypoxic myoclonus (Lance-Adams Syndrome) in post-cardiorespiratory arrest, a case presentation in elderly

Abstract

A clinical case report is presented of an elderly adult recovering from cardiac arrest who developed generalized myoclonus or Lance Adams syndrome in a tertiary care hospital. Myoclonus is defined as a sudden, brief muscle contraction (1).  The Lance Adams Syndrome is a form of post- hypoxic myoclonus, characterized by action myoclonus that typically involve the trunk, face, and extremities, and whose onset is days to weeks after a hypoxic brain injury. (2) The incidence of post-hypoxic myoclonus is 1. 3 cases per 100,000 people per year, so its differential diagnosis represents a challenge. The etiology may be secondary to cardiorespiratory arrest, anesthetic and surgical accidents, in addition to heart disease and drug overdose. Acute post-hypoxic myoclonus begins hours after the injury, sometimes begins as myoclonic status epilepticus, and if the patient survives, he will progress to a chronic phase with a poor or low life expectancy. Treatment is controversial, several articles agree that patients have shown better response to Levetiracetam, Magnesium Valproate, Lacosamide and Clonazepam.