Challenging Intensive Care Stimulus-Sensitive Myoclonus Following Prolonged Cardiothoracic Surgery
Hossam Malik Abdalla1*, Aakassh Sreedharan1, Roby Abraham1, Kabi-Khan Nazeer1
1Department of Neurology, University Hospital of North Midland, United Kingdom.
*Corresponding Author: Hossam Malik Abdalla, Department of Neurology, University Hospital of North Midland, United Kingdom. ORCID ID: http://orcid.org/0009 0003-0780-153X
https://doi.org/10.58624/SVOANE.2025.06.019
Received: June 09, 2025
Published: July 09, 2025
Citation: Abdalla HM, Sreedharan A, Abraham R, Nazeer KK. Challenging Intensive Care Stimulus-Sensitive Myoclonus Following Prolonged Cardiothoracic Surgery. SVOA Neurology 2025, 6:4, 98-100. doi. 10.58624/SVOANE.2025.06.019
Abstract
Stimulus-sensitive myoclonus is a rare condition that can occur following prolonged cardiothoracic surgery. It is similar to Lance-Adams syndrome, which is characterised by post-cardiac arrest myoclonus, and both conditions are related to nervous system hypoxia. In our case, myoclonus developed after a patient underwent an elective replacement of the ascending aorta and total aortic arch due to an aortic aneurysm. The myoclonus primarily affected the right side of the body and was triggered by touch, sound, and light. After a thorough evaluation and comprehensive investigations, we concluded that this case represented post-hypoxic brain injury stimulus-sensitive myoclonus, resembling Lance-Adams syndrome with both cortical and subcortical myoclonus. Eight antiseizure medications were trialled, and significant relief was only achieved with Perampanel.
Keywords: Lance-Adams; Syndrome; Post-cardiac; Hypoxia; Perampanel; Relief
