Yeniay Süt Nurşah, Yıldırım Miraç, Bektaş Ömer, Kendirli Tanıl, Teber Serap
Departments of Pediatric Neurology.
Pediatric Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey.
Clin Neuropharmacol. 2023;46(1):34-37. doi: 10.1097/WNF.0000000000000532. Epub 2022 Nov 9.
Lance-Adams syndrome is a rare but devastating disorder characterized by rest, action, and stimulus-sensitive myoclonus after cardiorespiratory arrest. We aimed to present a case of multidrug-resistant Lance-Adams syndrome that was successfully treated with oral phenobarbital therapy.
We report a previously healthy 11-year, 6-month-old boy was referred to our pediatric intensive care unit because of severe hypoxic ischemic brain injury due to sudden cardiorespiratory arrest. On the 15th day of hospitalization, he developed myoclonic jerks involving his limbs, trunk, and eyes. Despite many antiseizure medications in different combinations, myoclonic jerks persisted. Then, phenobarbital was started, and myoclonic jerks disappeared the next day. At the final evaluation, additional phenobarbital treatment was continued for 6 months and the patient remained myoclonus-free during this time.
To the best of our knowledge, this case is the first report describing significant improvement with phenobarbital in a patient with multidrug-resistant Lance-Adams syndrome. We suggest that phenobarbital is an effective option and should be kept in mind in patients with multidrug-resistant Lance-Adams syndrome.
兰斯-亚当斯综合征是一种罕见但极具破坏性的疾病,其特征为心肺骤停后出现静止性、动作性和刺激敏感性肌阵挛。我们旨在介绍一例多药耐药性兰斯-亚当斯综合征患者,该患者经口服苯巴比妥治疗后获得成功。
我们报告了一名此前健康的11岁6个月大男孩,因突发心肺骤停导致严重缺氧缺血性脑损伤,被转诊至我们的儿科重症监护病房。住院第15天,他出现了累及四肢、躯干和眼睛的肌阵挛性抽搐。尽管使用了多种不同组合的抗癫痫药物,肌阵挛性抽搐仍持续存在。随后开始使用苯巴比妥,第二天肌阵挛性抽搐消失。在最终评估时,继续额外使用苯巴比妥治疗6个月,在此期间患者未再出现肌阵挛。
据我们所知,该病例是首例描述苯巴比妥对多药耐药性兰斯-亚当斯综合征患者有显著改善作用的报告。我们建议苯巴比妥是一种有效的选择,对于多药耐药性兰斯-亚当斯综合征患者应予以考虑。