Abstract
Background: After cardiac arrest (CA), global cerebral ischemia results in brain tissue damage, inducing post-anoxic movement disorders (PMD) in some survivors. There are no current consensus recommendations to treat refractory PMD. Case Report: A 72-year-old male, smoker, presented with confusion, fever, and dyspnea. Progressive respiratory failure led to hemodynamic compromise and subsequent CA. He was resuscitated for 15 minutes but remained in a vegetative state. Magnetic resonance imaging (MRI) was normal and serial electroencephalograms were uncontributive. Median nerve somatosensory evoked potentials showed normal N20 waves. Six weeks after CA, while in a persistent vegetative state, the patient developed myoclonus and choreoathetosis requiring the resumption of sedatives to avoid ventilator asynchronies. A significant reduction in PMD was obtained with tetrabenazine, allowing withdrawal of the sedatives. Conclusion: In our case, tetrabenazine seemed to provide a better effect than other current medications (including levomepromazine) in PMD, allowing sedation and respiratory support withdrawal.
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