γ-Hydroxybutyric acid for alcohol-sensitive myoclonus with dystonia

Abstract

Alcohol-sensitive myoclonus can be associated with dystonic spasms.1 Conventional treatments and anticonvulsants occasionally produce some benefit, but not comparable with the improvement induced by alcohol.1 We report a patient with alcohol-sensitive myoclonus and dystonia who had a consistent and substantial benefit from oral γ-hydroxybutyric acid (GHB). Oral GHB is a drug that is effective both in the treatment of alcohol withdrawal2,3 and in maintaining abstinence from alcohol.4 A 37-year-old man was evaluated for severe disabling myoclonic jerks of the upper limbs, axial muscles, neck and cranial muscles, which were associated with dystonic spasms of the upper limbs and of the neck muscles. According to the Chadwick–Marsden Evaluation Scale for myoclonus,5,6 the patient’s score was 26 points. The hyperkinesias were not stimulus sensitive. They worsened under emotional stress and during the day, but the patient could control involuntary movements …