Abstract
Myoclonus is sudden development of involuntary, repetitive, irregular contractions of a group of muscles. Spinal tumours, infections, vascular lesions can result in spinal myoclonus. It can also be triggered by drugs used in spinal anaesthesia, placement of a subarachnoid catheter and use of contrast. Reports of myoclonus following spinal anesthesia in adults are extremely rare. We encountered a case of myoclonus following spinal anaesthesia which was successfully managed.
Highlights
Spinal myoclonus can be triggered by drugs used in spinal anaesthesia, placement of a subarachnoid catheter and use of contrast
The pathophysiology of spinal myoclonus seems to be an abnormal hyperactivity of the local dorsal horn interneurons with loss of inhibition of suprasegmental descending pathways usually restricted to a muscle, or a group of muscles.[3]
The abnormal movements seen in our patient following spinal anaesthesia were limited to both limbs and trunk with preserved sensorium, leading to possibility of spinal myoclonus or psychogenic movement disorder
Summary
Myoclonus is sudden development of involuntary, repetitive, irregular contractions of a group of muscles or occasionally of a single muscle triggered by an event within central nervous system.[1,2] Spinal myoclonus can be triggered by drugs used in spinal anaesthesia, placement of a subarachnoid catheter and use of contrast. 1mg of midazolam was administered intravenously and involuntary movements subsided. There was no evidence of weakness or cranial nerve dysfunction. These movements were clinically defined as spinal myoclonus. Serum calcium and glucose, were within normal limits. 20 min after administration of anaesthesia, she began to experience bilateral, involuntary myoclonic movement of both legs and arms, which was more intense in upper limb. Sensory function in her arms was intact. She was conscious and oriented, She was re-examined the following day and no abnormal neurologic finding was evident
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