Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027066 (myoclonus)
 4,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Beagles, implanted with cortical and subcortical electrodes, were given etomidate i.v. (1 mg/kg) over a period of 10 sec. The effects on the EEG were compared with those obtained with 7 mg/kg of methohexital. Both compounds induced hypnosis for a duration of approximately 8 min. The EEGs showed a remarkable similarity. Visual inspection of the records as well as power spectrum analysis revealed a sustained theta-activity with underlying fast activity. The configuration of the waves was rather sharp. The power obtained after etomidate was, however, 2 to 3 times that obtained after methohexital. When the animals awoke from etomidate-induced hypnosis slow waves appeared and were followed by alpha-activity, whereas after methohexital-hypnosis beta-activity predominated. Etomidate slightly increased heart rate, but respiratory depression was not observed. Methohexital caused pronounced tachycardia and apnoea. In 3 out of 6 dogs methohexital caused myoclonus of the hind legs upon awakening from anaesthesia. Etomidate induced myoclonus in one dog during hypnosis.
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PMID:Electroencephalographic study of the short-acting hypnotics etomidate and methohexital in dogs. 63 Nov 87

Clonic and tonic seizure-like movements of the extremities were observed during induction of anaesthesia with sevoflurane in a 9-yr-old girl. The tonic movements were associated with respiratory alkalosis and were not abolished by an i.v. injection of thiamylal 75 mg. Arterial pressure, heart rate and body temperature remained normal during the episode. Ventilation was assisted easily and then controlled via a face mask. No neurological abnormalities were obvious after the anaesthesia. The movements may have been the result of seizure activity in the central nervous system, or myoclonus of the extremities.
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PMID:Seizure-like movements during induction of anaesthesia with sevoflurane. 154 Apr 67

Sixteen ASA class II or III male patients (aged, 52 to 66 years) undergoing elective cardioversion were randomly assigned to receive either thiopental or etomidate according to an observer-blinded, parallel study design. The appropriate drug was administered in 2-mL aliquots every 15 seconds until the patient no longer responded to verbal commands, at which time cardioversion was attempted. The total dose for induction was 0.22 +/- 0.2 mg/kg and 3.2 +/- 0.4 mg/kg for etomidate and thiopental, respectively. The cardiorespiratory data after induction were evaluated for maximal percent change from baseline. The baseline heart rate was 106 +/- 6 beats/min and 98 +/- 8 beats/min for the etomidate and thiopental groups, respectively (mean +/- SEM). The heart rate decreased 5% after induction with etomidate and increased 7% with thiopental (P less than 0.05). The baseline mean arterial pressure (MAP) was 96 +/- 3 mm Hg and 105 +/- 11 mm Hg for the etomidate and thiopental groups, respectively (mean +/- SEM). The MAP decreased 4% with etomidate and 3% with thiopental. Respiratory rate was significantly increased by 22% after etomidate compared with a 22% decrease in respiratory rate with thiopental (P less than 0.05). Seven of eight patients in the thiopental group required only one countershock, whereas four of eight patients in the etomidate group required only one shock. One patient in each group could not be successfully cardioverted. Recovery time and clinical side effects were similar between groups except for mild myoclonus in the etomidate group. Titration to effect of either etomidate or thiopental provided satisfactory anesthesia for elective cardioversion in hemodynamically stable patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A comparison of etomidate and thiopental anesthesia for cardioversion. 176 19

Elective cardioversion is a short procedure performed under general anesthesia for the treatment of cardiac dysrhythmias. Selection of the anesthetic agent is important, because a short duration of action and hemodynamic stability are required. Forty-four patients scheduled for elective cardioversion in the coronary care unit were studied prospectively. All patients were randomly assigned, according to the last digit of their clinical record number, to receive one of the four anesthetic agents studied: group 1, 12 patients who received 3 mg/kg of sodium thiopental; group 2, 10 patients who received 0.15 mg/kg of etomidate; group 3, 12 patients who received 1.5 mg/kg of propofol; and group 4, 10 patients who received 0.15 mg/kg of midazolam. All patients also received 1.5 micrograms/kg of fentanyl 3 minutes before induction. All four drugs provided satisfactory anesthesia for cardioversion and there were no major complications. Midazolam produced a more prolonged duration of effect and more interindividual variability. Propofol was associated with hypotension and a higher incidence of apnea, and its duration of action was similar to that of etomidate or thiopental. Etomidate produced myoclonus and pain on injection; however, it was the only agent that did not decrease arterial blood pressure. Thiopental reduced blood pressure but otherwise seemed an appropriate anesthetic for this procedure. In conclusion, all four anesthetic agents were acceptable for cardioversion, although their pharmacological differences suggest specific indications for individual patients.
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PMID:Anesthesia for elective cardioversion: a comparison of four anesthetic agents. 176 20

The neurological assessment of patients admitted to the intensive care unit after successful resuscitation from cardiopulmonary arrest may be difficult. We describe the cases of two patients who developed myoclonus within 24 hours of hypoxic respiratory and cardiac arrest. Initially, the clonic movements were thought to be generalised convulsions and were treated as such, until it became evident that the patients were aware and distressed. Posthypoxic myoclonus is a rare complication of successful cardiopulmonary resusitation. Recognition depends on the awareness that the syndrome exists, and is important so that correct therapy can be instituted. There may be important prognostic implications. Both our patients had normal intellectual recovery with moderate residual neurological disability from their movement disorder.
Anaesthesia 1991 Mar
PMID:Posthypoxic myoclonus (the Lance-Adams syndrome) in the intensive care unit. 201 97

We report a patient who developed paraplegia following percutaneous nephrolithotresis of the left kidney under epidural anaesthesia. The cause of the paraplegia was unknown, but occlusion of the anterior spinal artery or central arteries and arachnoiditis, possibly due to the epidural anaesthesia, may have taken part in the onset and progression of the paralysis. The patient had spinal myoclonus corresponding to the spinal levels where myelomalacia was found by magnetic resonance (MR) imaging.
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PMID:Post-operative paraplegia with spinal myoclonus possibly caused by epidural anaesthesia: case report. 202 78

A case is presented in which myoclonus occurred after epidural diamorphine infusion. Reports of this phenomenon following other epidural drugs and possible mechanisms are discussed.
Anaesthesia 1991 Jun
PMID:Myoclonic spasms after epidural diamorphine infusion. 204 68

Anaesthesia for elective direct current cardioversion (DCC) was induced with propofol (Diprivan) 1.2 mg/kg in 28 patients and with 0.2 mg/kg etomidate (Hypnomidate) in 20 patients. These mostly high risk patients (NYHA class II to III) were successfully treated with defibrillation. Blood pressure and heart rate were recorded before and after induction and at 2 minutes intervals up to 20 minutes after DCC. Both anaesthetic agents caused mild hypotension. Heart rate did not change significantly after induction but fell significantly after DCC from the mean value of 124 +/- 26 bpm and 122 +/- 37 bpm to 94 +/- 19 bpm and to 91 +/- 19 bpm in propofol and etomidate treated patients respectively. Four patients became apnoeic necessitating assisted ventilation for approximately four minutes. All propofol treated patients had rapid recovery times and opened eyes on command within 5.6 +/- 1.9 minutes after induction, and were fully orientated about 4 minutes later also. Complete amnesia was observed in all patients in this group. In contrast etomidate induced anaesthesia did not cause respiratory depression, but the recovery time was longer. Four patients of this group complained of recall of DCC. In 7 patients due to involuntary movements or myoclonus, after induction with etomidate reliable EKG monitoring appeared to be difficult.
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PMID:[Anesthesia for cardioversion. A comparison of propofol and etomidate]. 220 24

Rhythmic palatal myoclonus (RPM) is a rare movement disorder consisting of continuous synchronous jerks of the soft palate, muscles innervated by other cranial nerves and, rarely, trunk and limb muscles. It usually develops secondary to brainstem or cerebellar disease (symptomatic RPM). Some patients, however, fail to show evidence of a structural lesion (essential RPM). A total of 287 cases with RPM from the literature including 210 cases with symptomatic and 77 cases with essential RPM have been reviewed and analysed statistically to look for criteria separating the two conditions. Patients with essential RPM usually have objective earclicks as their typical complaint which is rare in the symptomatic form. Eye and extremity muscles are never involved. The jerk frequency is lower in essential than in symptomatic RPM. Patients with essential RPM are younger and have a balanced sex distribution as compared with a male preponderance in the symptomatic form. The rhythmicity of RPM seems to be more profoundly influenced by sleep, coma and general anaesthesia in essential than in symptomatic RPM. We conclude from these results that essential RPM should be separated as a distinct clinical entity. Symptomatic RPM is a rhythmic movement disorder whose pathogenesis is quite well established. The cells of the hypertrophied inferior olives are believed to represent the oscillator. Among other possibilities, essential RPM may represent its functional analogue, based on transmitter changes only. Such a relationship could be of theoretical interest for the understanding of rhythmic hyperkinesias in general.
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PMID:Symptomatic and essential rhythmic palatal myoclonus. 227 39

We report a case of periodic leg movements (PLM) observed in an 86-year-old man during either midthoracic epidural anesthesia or spinal anesthesia. The PLM observed were stereotyped (extension of the big toe in combination with partial flexion of the ankle, knee, and hip lasting 3-5 s) and repetitive (interevent intervals between jerks were 20-40 s) for about 120 and 30 min respectively. The patient was awake but unaware of the PLM unless reminded. The present case was quite similar to sleep-related (noctural) myoclonus (SRM) in every respect except for its occurrence during wakefulness. SRM is more prevalent in the elderly population but its mechanism remains to be elucidated. Previously, we had reported a case of PLM observed in an elderly man with SRM. In our two cases, PLM were seen only while the local anesthetic was acting on the spinal cord; therefore, these anesthesia-related PLM (ARPLM) may suggest that the spinal cord is involved. In particular, we consider that physiological changes seen commonly during non-rapid-eye-movement sleep and a certain phase of anesthesia, such as suppression of the descending inhibitory pathway, and pyramidal tract dysfunction are relevant to ARPLM. In addition, the concomitant alteration of the blood flow in the leg and changes due to aging of the spinal cord may also be involved.
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PMID:Periodic leg movements during either epidural or spinal anesthesia in an elderly man without sleep-related (nocturnal) myoclonus. 235 97


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