Chlormethiazole in the Management of the Opsoclonus-Myoclonus Syndrome

Author:

Vilchez JJ1,Lago A1,Burguera JA1,Yaya R1,Casanova V1

Affiliation:

1. Department of Neurology, University Hospital “La Fe”, 46009 Valencia, Spain

Abstract

Two instances of successful treatment of the rare ocular dyskinesia, opsoclonus, with chlormethiazole are reported. A 65-year-old woman had the opsoclonus-myoclonus syndrome associated with carcinoma of the breast; her myoclonia and opsoclonus did not respond to intravenous diazepam or phenytoin. Treatment with intravenous chlormethiazole resulted in rapid control of her myoclonic attacks, followed by slower but complete resolution of the opsoclonus. Following control of the acute symptoms the patient was transferred to an oral chlormethiazole maintenance dose which was further reduced and subsequently discontinued after 5 months, when the patient's overall clinical status had improved. A 53-year-old man with opsoclonia, myoclonia, ataxia and encephalopathy, not associated with neoplasia, was given immunosuppressor drugs to establish basal control, and oral chlormethiazole for symptomatic treatment. Almost immediately after the initial dose of chlormethiazole the patient became more orientated; he was sedated and the agitation and myoclonic fits were brought under control quite quickly. The opsoclonus responded progressively and was completely resolved after a few days. The initial oral dose of chlormethiazole was gradually reduced and was discontinued after 5–6 months. Chlormethiazole was well tolerated; it may have an important role in the management of the rare opsoclonus-myoclonus syndrome.

Publisher

SAGE Publications

Subject

Biochemistry, medical,Cell Biology,Biochemistry,General Medicine

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Childhood opsoclonus-myoclonus syndrome: diagnosis and treatment;Expert Review of Neurotherapeutics;2016-04-27

2. Anti-Ri antibody opsoclonus-myoclonus syndrome and breast cancer: A case report and a review of the literature;Journal of Surgical Oncology;2004

3. Paraneoplastic syndromes of gynecologic neoplasms.;Journal of Clinical Oncology;1997-03

4. Myoclonus;Current Opinion in Neurology;1995-08

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