engleski

Spinal myoclonus after cervical spine extension procedure: case report

A 27-year-old male patient came to our emergency department presented with brief, irregular muscle contractions on the arms and legs. The attacks repeated, lasted less than a minute and ended with hyperextension of the neck and the back (opisthotonos). In this period the patient was conscious and complained of a headache and muscle pains. In between the attacks he had normal neurological status. The myoclonic jerks were induced mostly by movement but also occurred when the patient laid down calmly. They began a few minutes after cervical spine extension procedure where the patient went due to neck and back pain. This was his second neck extension treatment performed in a non- medical institution. Few days before he had also extension therapy for the lumbar spine that was completed successfully. We performed extensive examinations which resulted in normal findings (CT scan of the brain, MRI of the brain and cervical spine, electroencephalogram, color Doppler of the carotide and vertebral artery, somatosensory evoked potential of median and tibial nerve). In the laboratory only increase in creatine kinase level was reported and the rest of the findings were unremarkable (thyroid hormones, liver and renal parameters, electrolytes, red and white blood count). All toxicology findings in serum and urine were negative (benzodiazepines, tricyclic antidepressant, amphetamines, metamphetamines, ecstasy, cocaine, methadone, opiates). The patient was treated with benzodiazepines and baclofen and after 2 h the myoclonic jerks completely ceased. The patient recovered completely and during the remainder of his stay on the ward he complained only of muscle pains. In his past medical history he had streptococcal inflammation of the hip and febrile convulsions in infancy. Otherwise, he was healthy. He does not smoke, does not drink and does not take drugs.

cervical vertebrae - surgery ; myoclonus – etiology ; postoperative complications ; spinal cord – surgery ; adults ; humans ; male ; case reports ; letter

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