Ilik Faik, Kemal Ilik Mustafa, Cöven Ilker
Department of Neurology, Elbistan State Hospital, Kahramanmaras, Turkey.
Department of Neurosurgery, Faculty of Medicine, Mevlana University, Konya, Turkey.
Iran J Child Neurol. 2014 Spring;8(2):57-9.
Chronic post-hypoxic myoclonus, also known as Lance-Adams syndrome (LAS) is a neurological complication characterized by uncontrolled myoclonic jerks following cardiac arrest. In this article, clinical manifestation and symptomatic treatment options are discussed especially concerning the rationale of use of levatiracetam in patients with Lance-Adams syndrome. Clinical presentation is action myoclonus associated with cerebellar ataxia, postural imbalance, and very mild intellectual deficit. An 18-year-old female patient was admitted to our intensive care unit in a coma. She had a cardiorespiratory arrest after a splenectomy in a local hospital. Then, myoclonic movements were continuously observed over the entire body, including the face. On day 14 of hospitalization, we started levatiracetam 1000 mg daily. The frequency of convulsion movements was reduced. The patient level of consciousness was 15 on the Glasgow coma scale (GCS) on the Mini-Mental State Examination (MMSE) score was 23 out of 30. She was later transferred to the rehabilitation department. Vigilance is required to ensure early diagnosis and timely intervention for the myoclonic jerks. We would like to emphasize that LAS should be considered in patients with the myoclonic jerks following cardiac arrest and that levatiracetam therapy may be useful as treatment.
慢性缺氧后肌阵挛，也称为兰斯-亚当斯综合征（LAS），是一种神经并发症，其特征为心脏骤停后出现不受控制的肌阵挛性抽搐。本文讨论了临床表现和对症治疗选择，尤其涉及左乙拉西坦在兰斯-亚当斯综合征患者中的使用原理。临床表现为与小脑共济失调、姿势失衡和非常轻微的智力缺陷相关的动作性肌阵挛。一名18岁女性患者昏迷状态被收入我们的重症监护病房。她在当地一家医院行脾切除术后发生心肺骤停。随后，在包括面部在内的全身持续观察到肌阵挛运动。住院第14天，我们开始每日给予左乙拉西坦1000毫克。抽搐运动的频率降低。患者格拉斯哥昏迷量表（GCS）评分为15分，简易精神状态检查表（MMSE）评分为30分中的23分。她后来被转至康复科。需要保持警惕以确保对肌阵挛性抽搐进行早期诊断和及时干预。我们想强调，心脏骤停后出现肌阵挛性抽搐的患者应考虑兰斯-亚当斯综合征，左乙拉西坦治疗可能作为一种治疗方法有效。
