Gpi pallidal stimulation for Lance-Adams syndrome

Abstract

Posthypoxic myoclonus (PHM) is a rare syndrome of action and intention myoclonus that occurs in patients who survive a cardiopulmonary arrest (CPA).1,–,4 Lance-Adams syndrome (LAS) is the chronic type of PHM predominantly characterized by action myoclonus starting days to weeks after hypoxic brain insult as patients regain consciousness.1,–,3 Myoclonus can be cortical or subcortical and both forms can coexist.1,3,5 The basal ganglia may be involved in the pathophysiology of myoclonus.4,6 Stereotactic functional surgery has not been used to treat LAS. ### Classification of evidence. Class IV, case report. This is a single observation study without controls. ### Case report. A 71-year-old man developed a complete left hemiparesis due to right putaminal hemorrhage on September 2, 2008 (figure 1A). After 14 days of conservative treatment, he went into CPA due to pulmonary embolism. He was rescued within a few minutes and recovered from a comatose state 2 days after CPA; however, jerky movements appeared on his right hemibody. As his consciousness level improved, his myoclonic movements became exacerbated. PHM was …