In this case report, two patients are presented who developed myoclonic status epilepticus after severe hypoxic brain injury and were diagnosed as having Lance-Adams syndrome (post-hypoxic myoclonus). The diagnosis of Lance-Adams syndrome and the controversies and difficulties that surround its diagnosis and treatment and other aspects of prognostication in cardiac arrest are reviewed.
WijdicksEFHijdraAYoungGB. Practice parameter prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology2006;67: 203–10.
2.
BoyleAStaniciuDLewisS. Can middle grade and consultant emergency physicians accurately interpret computed tomography scans performed for head trauma? Cross-sectional study. Emerg Med J2009;26: 583–85.
3.
WijdicksEFMParisiJESharbroughFW. Prognostic value of myoclonus status in comatose survivors of cardiac arrest. Ann Neurol1994;35: 239–43.
4.
HuiACFChengCLamA. Prognosis following postanoxic myoclonus status epilepticus. Eur Neurol2005;54: 10–13.
5.
YoungGBGilbertJJZochodneDW. The significance of myoclonic status epilepticus in postanoxic coma. Neurology1990;40: 1843–48.
6.
LanceJAdamsR. D. The syndrome of intention or action myoclonus as a sequel to hypoxic encephalopathy. Brain1963;86: 111–36.
7.
PearigenPGwinnR. The effects in vivo of hypoxia on brain injury. Brain Res1996;725: 184–91.
8.
MiyamotoOAuerRN. Hypoxia, hyperoxia, ischaemia and brain necrosis. Neurology2000;54: 362–71.
9.
SimonRP. Hypoxia versus ischaemia. Neurology1999;52: 7–8.
10.
SloperJJJohnsonP. Selective degeneration of interneurons in the motor cortex of infant monkeys following controlled hypoxia: a possible cause of epilepsy. Brain Res1980;198: 204–09.
11.
MorrisHRHowardRSBrownP. J Early myoclonic status and outcome after cardiorespiratory arrest. J Neurol Neurosurg Psychiatry1998;64: 267–68.
12.
ZhangYXLiuJRJiangB. Lance—Adams syndrome: a report of two cases. J Zhejiang University Sci2007;8: 715–20.
13.
DattaSHartGK. Post hypoxic myoclonic status: The prognosis is not always bad. Crit Care Resusc2009;11: 39–41.
14.
TeasdaleGJennetB. Assessment of coma and impaired consciousness. Lancet1974;304: 81–84.
15.
GillM. A comparison of the GCS to simplified alternate scores for the prediction of TBI outcomes. Ann Emergency Med2005;45: 37–42.
16.
SteffenIHasperD. Mild therapeutic hypothermia alters neuron specific enolase as an outcome predictor after resuscitation. Crit Care2010;14: R69.
