Myoclonus following Spinal Anesthesia

Fox, Ellie; Villanueva, Raymond; Schutta, Henry S.

doi:10.1097/00132586-198004000-00052

Cited by 4 publications

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“…The patient underwent spinal anesthesia on three separate occasions, with SM occurring only at the second occasion. According to previous case reports that recorded the patients' past NA histories, some patients with SM-NA had previously undergone uneventful spinal anesthesia [2][3][4]. On the other hand, a case of repeated SM-NA was reported [5].…”

Section: Discussionmentioning

confidence: 99%

“…Acute dystonia includes muscle spasms in the tongue, face, neck, and back; parkinsonism includes bradykinesia, rigidity, and tremor; and akathisia includes motor restlessness [7]. The signs of SM-NA are lightninglike muscle jerks often confined to the extremities [2][3][4][5][6], whereas EPS is characterized by sustained muscle contractions causing twisting-like abnormal movements and postures, which may affect the facial muscles and may be generalized, involving the trunk as well as limbs [8,9]. Although it may be difficult to differentiate droperidol-induced EPS under NA from SM-NA, careful observation of the involuntary movement patterns may make it possible to make the distinction.…”

Section: Discussionmentioning

confidence: 99%

“…Because SM develops following NA, it has been considered that NA may be responsible for the myoclonus. Furthermore, several articles related to SM following NA (SM-NA) speculate that local anesthetics interfere with the spinal cord, thereby leading to SM-NA [2][3][4][5][6]. However, the exact mechanism and prevalence of this movement disorder remain to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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A case of spinal myoclonus in a patient with elective cesarean section

Shiratori¹,

Hotta

Satoh

et al. 2018

JA Clin Rep

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Background: Transient myoclonic involuntary movements, typically referred to as spinal myoclonus (SM), rarely develop in the extremities following neuraxial anesthesia (NA). NA indications in patients with history of SM following NA (SM-NA) are unknown. Case presentation: A 33-year-old woman developed SM-NA after elective cesarean section (CS). Approximately 130 min after spinal anesthesia induction, she began exhibiting involuntary movements, which became most severe after approximately 3 h. The involuntary movements gradually decreased without treatments and disappeared after approximately 5 h. The patient underwent CS on three occasions. The first CS (age, 29 years) was under a combination of spinal and epidural anesthesia. The third CS (age, 35 years) was completed using only spinal anesthesia. There were no neurological events during the postoperative courses for the first and third CS. Conclusions: SM-NA can unexpectedly occur, and history of SM-NA may not be contraindicative for repeated NA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A case of spinal myoclonus in a patient with elective cesarean section

Shiratori¹,

Hotta

Satoh

et al. 2018

JA Clin Rep

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“…The reported causes of spinal myoclonus reviewed by Jankovic 1986 included spinal tumour, vacuolar degeneration of anterior horn cells, spinal root lesion, myelitis, spinal anaesthesia, penicillin, arteriovenous malformation, herpes zoster and other infections, meningo myelocele, injury to the spine or the brachial plexus, spondylosis, and various neurodegenerative processes. Fox (1979) reported spinal myoclonus following lumbar anaesthesia, but we have not come across any cases of spinal myoclonus following epidural anaesthesia in the literature.…”

Section: Discussionmentioning

confidence: 90%

Post-operative paraplegia with spinal myoclonus possibly caused by epidural anaesthesia: case report

1991

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SummaryWe report a patient who developed paraplegia following percutaneous nephrolithotresis of the left kidney under epidural anaesthesia. The cause of the paraplegia was unknown, but occlusion of the anterior spinal artery or central arteries and arachnoiditis, possibly due to the epidural anaesthesia, may have taken part in the onset and progression of the paralysis. The patient had spinal myoclonus corresponding to the spinal levels where myelomalacia was found by magnetic resonance (MR) imaging.

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“…Segmental myoclonus is a rare movement disorder characterized by myoclonic involvement of a muscle or a group of muscles supplied by a few contiguous segments of the brain stem or spinal cord 2 . Several causes of spinal myoclonus have already been described including spinal tumors, infections, vascular lesions, spinal anesthesia, AIDS and demyelinating diseases, but in a few cases the etiology remains unknown [2][3][4][5] .…”

mentioning

confidence: 99%

A case of primary spinal myoclonus: clinical presentation and possible mechanisms involved

Campos

Limongi

Machado

et al. 2003

Arq. Neuro-Psiquiatr.

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-Spinal myoclonus is a rare movement disorder characterized by myoclonic involvement of a group of muscles supplied by a few contiguous segments of the spinal cord. Structural lesions are usually the cause, but in primary spinal myoclonus the etiology remains unknown. We present the case of a 26-year-old woman with cervical spinal myoclonus in which both clinical and electromyographic findings pointed to the segment C1-C3 as the origin of the myoclonus. Laboratorial examinations were normal and no structural lesion was found in magnetic resonance imaging (MRI). Botulinum toxin type A was injected in infrahyoid muscles and cervical paraspinal musculature. The patient remained free of symptoms for almost five months. The pathophysiology of spinal myoclonus remains speculative, but there is evidence that various possible mechanisms can be involved: loss of inhibitory function of local dorsal horn interneurons, abnormal hyperactivity of local anterior horn neurons, aberrant local axons re-excitations and loss of inhibition from suprasegmentar descending pathways.KEY WORDS: spinal myoclonus, segmental myoclonus, primary myoclonus.Um caso de mioclonia espinhal primária: apresentação clínica e possíveis mecanismos envolvidos Um caso de mioclonia espinhal primária: apresentação clínica e possíveis mecanismos envolvidos Um caso de mioclonia espinhal primária: apresentação clínica e possíveis mecanismos envolvidos Um caso de mioclonia espinhal primária: apresentação clínica e possíveis mecanismos envolvidos Um caso de mioclonia espinhal primária: apresentação clínica e possíveis mecanismos envolvidos RESUMO -A mioclonia espinhal é um raro distúrbio do movimento, caracterizado pelo envolvimento mioclônico de um grupo de músculos inervados por segmentos medulares contíguos. Lesões estruturais costumam ser a causa, mas na mioclonia espinhal primária a etiologia não é definida. Apresentamos o caso de uma mulher de 26 anos com mioclonia cervical espinhal em quem os achados clínicos e eletrofisiológicos apontaram o segmento C1-C3 como origem das mioclonias. Os exames laboratoriais foram normais e nenhuma lesão estrutural foi encontrada à ressonância. A toxina botulínica tipo A foi injetada nos músculos infrahioideos e na musculatura paraespinhal cervical. A paciente permaneceu assintomática por cinco meses. A patofisiologia da mioclonia espinhal continua especulativa, mas há evidências de que vários mecanismos possam estar envolvidos: perda da função inibitória de interneurônios da coluna dorsal, hiperatividade anormal de neurônios do corno anterior da medula, re-excitações axonais locais aberrantes e perda do efeito inibitório de vias descendentes suprasegmentares.PALAVRAS-CHAVE: mioclonia espinhal, mioclonia segmentar, mioclonia primária.

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Myoclonus following Spinal Anesthesia

Cited by 4 publications

References 0 publications

A case of spinal myoclonus in a patient with elective cesarean section

A case of spinal myoclonus in a patient with elective cesarean section

Post-operative paraplegia with spinal myoclonus possibly caused by epidural anaesthesia: case report

A case of primary spinal myoclonus: clinical presentation and possible mechanisms involved

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