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

Abstract

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.Uvod. Hronicni postanoksicni mioklonus, poznat i kao Lance-Adamsov sindrom, moze se javiti nakon hipoksicne povrede mozga i rezistentan je na farmakolosku terapiju. Prikaz bolesnika. Prikazan je bolesnik sa postankosicnim mioklonusom i izrazenim mioklonicnim trzajevima koji su doveli do njegove potpune onesposobljenosti. Mioklonije nisu reagovale na uobicajene lekove kao sto je valproat i klonazepam pojedinacno ili u kombinaciji. Poboljsanje akcionog mioklonusa postignuto je tek nakon uvodjenja levetiracetama u dodatnoj terapiji. Zakljucak. Iako jos nije moguce potpuno izlecenje sindroma Lans-Adams, levetiracetat znatno popravlja funkcionalni i nivo ukupnog kvaliteta zivota bolesnika sa ovim poremecajem.