Periodic eye opening and upward eye deviation accompanied by burst-suppression, as an isolated clinical manifestation of acute post-hypoxic myoclonus

DERİCİOĞLU N., ARSAVA E. M., TOPÇUOĞLU M. A.

EPILEPTIC DISORDERS, cilt.17, sa.1, ss.77-83, 2015 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 1
  • Basım Tarihi: 2015
  • Doi Numarası: 10.1684/epd.2015.0731
  • Dergi Adı: EPILEPTIC DISORDERS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.77-83
  • Anahtar Kelimeler: cardio-pulmonary arrest, post-hypoxic myoclonus, periodic eye opening, burst-suppression, levetiracetam, EEG PATTERN, RESUSCITATION, PHYSIOLOGY, MOVEMENTS
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Various movement disorders have been described following hypoxic-ischaemic brain injury. Here, we present a 72-year-old female patient who developed periodic opening and upward deviation of the eyes as an isolated clinical finding, within 24 hours after cardio-pulmonary arrest. These movements were accompanied by burst-suppression on EEG, and both clinical and electrophysiological findings were suppressed 18 hours after intravenous levetiracetam infusion. The strictly periodic nature of both EEG discharges and eye opening with vertical deviation suggest a cause due to either activation of a subcortical/brainstem pacemaker reciprocally stimulating the cortex, or, alternatively, post-anoxic burst activity of viable cortical neural networks, somehow stimulating the relevant oculomotor nuclei. Together with previous similar cases, our case expands the spectrum of post-resuscitation myoclonus syndromes with the addition of this rare isolated oculopalpebral subtype. [Published with video sequence]