Valproic Acid in the Treatment of Nonepileptic Myoclonus

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Abstract
Myoclonic disorders are often disabling and difficult to treat and present a therapeutic challenge to the physician. Attempts to control myoclonic jerks have been made with several drugs, of which only clonazepam1 and L-5-hydroxytryptophan (L-5-HTP)2 seem to have long-term value in practice. This article reports three cases of nonepileptic myoclonus that severely interfered with normal function. One patient suffered from postanoxic action myoclonus,3 and two patients suffered from nocturnal myoclonus.4 Several kinds of medication had proved ineffective, but valproic acid alone produced rapid and enduring relief. REPORT OF CASES Case 1.—A 52-year-old man had fungal endocarditis and septicemia develop one month after cardiac valvular replacement. The valve prosthesis was changed in a replacement. After surgery, pericardial bleeding caused cardiac tamponade and asystole one week after the replacement. Anoxic brain damage with cerebral and brainstem signs and severe action myoclonus resulted. The patient was unconscious for two