Abstract
The NMDA receptor antagonist, memantine, is used for symptomatic treatment of Alzheimer disease (AD).1 A 76-year-old man with mixed AD and vascular dementia, hypertension, and chronic kidney disease developed head and upper extremity myoclonus (video on the Neurology ® Web site at [Neurology.org][1]). Memantine was prescribed (5 mg/d) 6 days before onset. Myoclonus disappeared after memantine withdrawal (video). Amantadine, which also has NMDA receptor antagonistic activity, can cause myoclonus.2 Memantine is primarily excreted unchanged via the kidney; its elimination half-life is increased with renal impairment,1 which may have induced myoclonus in this case. Blockade of NMDA receptors may play an important role in the pathogenesis of myoclonus. [1]: http://Neurology.org
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