Lee Geon Jae, Kim Hyoung Seop
Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Brain Neurorehabil. 2021 Nov 19;15(1):e10. doi: 10.12786/bn.2022.15.e10. eCollection 2022 Mar.
Myoclonus is an abrupt arrhythmic condition with shock-like movements that can be triggered by sensory stimuli, affecting the trunk or limbs during voluntary movement. Since motor symptoms are often not easily treatable, various pharmacological treatment options have been suggested. We report a case of using intrathecal baclofen (ITB) therapy in a patient with hypoxic brain injury (HBI), leading to the alleviation of myoclonus. A 29-year-old woman repeatedly presented with generalized myoclonus and multiple joint contractures at both upper and lower limbs after resuscitation. She cried during intractable myoclonus events, making it difficult for her to maintain a good sleep pattern. Due to the persistent status of multiple joint contractures and intractable myoclonus, we offered an ITB trial to control her symptoms. After ITB, her total scores on the Unified Myoclonus Rating Scale progressively improved as the doses of baclofen increased. Therefore, ITB therapy should be considered as a substantial option in the management of intractable myoclonus in patients with HBI to prevent various complications and improve the quality of life.
肌阵挛是一种突发的、无节律性的状况，伴有类似电击样的动作，可由感觉刺激诱发，在自主运动时影响躯干或四肢。由于运动症状往往不易治疗，人们提出了各种药物治疗方案。我们报告一例在缺氧性脑损伤（HBI）患者中使用鞘内注射巴氯芬（ITB）治疗，从而缓解肌阵挛的病例。一名29岁女性在复苏后反复出现全身性肌阵挛以及双上肢和双下肢多处关节挛缩。在难治性肌阵挛发作期间她会哭泣，这使她难以维持良好的睡眠模式。由于多处关节挛缩和难治性肌阵挛的持续状态，我们进行了ITB试验以控制她的症状。注射ITB后，随着巴氯芬剂量增加，她在统一肌阵挛评定量表上的总分逐渐改善。因此，在HBI患者难治性肌阵挛的管理中，应将ITB治疗视为一种重要选择，以预防各种并发症并提高生活质量。
