Quiz Form

Question Date: 05/09/2023

Question: Six days after resuscitation from a cardiorespiratory arrest, a 61-year-old man is experiencing frequent action-induced myoclonic jerks that impair his ability to fully participate in physical therapy. Which of the following medications should be prescribed as a first-line agent to reduce the myoclonus?

Options:

• Carbamazepine
• Lamotrigine
• Levetiracetam
• Zonisamide

Correct Answer: Levetiracetam

Explaination: Myoclonus can be treated symptomatically if the symptoms are bothersome or interfere with normal functioning. In this case, the postanoxic myoclonus is interfering with physical therapy. First-line agents in the treatment of myoclonus include valproate, clonazepam, and levetiracetam. Clonazepam is not recommended for long-term use because of the development of sedation and tolerance. Topiramate and zonisamide are used as second-line agents. Carbamazepine and lamotrigine have no role in the treatment of myoclonus and actually may exacerbate myoclonus in some cases.

Reference: Espay AJ, Chen R. Myoclonus. Continuum (Minneap Minn). 2013 Oct19(5 Movement Disorders)1264-86. doi 10.121201.CON.0000436156.54532.1a. PMID 24092290.