Chronic posthypoxic myoclonus: Lance-Adams syndrome.
Emily Dean, Samah Hussain, Eleanor Garstang et al.
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Case in brief
A man in his 20s developed chronic intentional myoclonus following two cardiac arrests, leading to persistent generalized myoclonic seizures. Despite treatment with multiple antiepileptics and sedation, seizures continued. Diagnostic imaging and EEG ruled out myoclonus status epilepticus, supporting a diagnosis of Lance-Adams syndrome. Ketamine was used to terminate the seizures, and antiepileptic medications were adjusted to manage residual myoclonus.
Diagnostic / clinical pearl
Clinicians should consider Lance-Adams syndrome in patients with persistent myoclonus after hypoxic events, especially when there is no significant brain injury and consciousness is preserved.
Why it matters
This case underscores the diagnostic challenges of Lance-Adams syndrome and the importance of distinguishing it from myoclonus status epilepticus to guide appropriate management.