Rábano-Suárez et al. [4] |
Case 1: 63, M |
Case 1: Bilateral pneumonia, mechanically ventilated |
Case 1: 9 days |
Case 1: anosmia; myoclonic storm, more involving upper half of body; auditory and tactile stimulus sensitive; somnolence |
Case 1: LEV, CLN, IVMP 1g/day for 5 days. PLEX × 5 cycles. Patient had sustained improvement only after PLEX. |
Case 2: 88, F |
Case 2: Bilateral pneumonia |
Case 2: 3 weeks |
Case 2: anosmia, mild myoclonus, mild hypersomnia |
Case 2: resolved with IVMP 250 mg/day for 3 days |
Case 3: 76, M |
Case 3: Bilateral pneumonia |
Case 3: 11 days |
Case 3: anosmia, mild myoclonus |
Case 3: LEV, CLN, IVMP 250 mg/day for 3 days. Patient had delayed improvement after 2 weeks. |
CSF: done for case 1 and 3, normal |
Muccioli et al. [5] |
58, M |
Respiratory distress, mechanically ventilated |
3 weeks |
Brief agitation for 2 days-self resolved followed by multifocal myoclonus: action and tactile stimulus sensitive; diffuse, but more prominent in right proximal lower limb - causing marked disablility to stand |
Symptoms resolved completely with symptomatic treatment with CLN and LEV in 5 days. |
HCQ, tocilizumab remdesivir given |
Khoo et al. [6] |
65, F |
Bilateral lung infiltrates seen |
7 days |
Patient had baseline Alzheimer’s disease |
IVMP 1 g /day for 3 days followed by oral steroid taper with prednisolone |
Unilateral onset of myoclonus generalised within 2 days, stimulus sensitive, with hyperkplexia to tactile, visual and auditory stimulus |
Patient had significant improvement in cognition and myoclonus. Cognition improved to baseline. Myoclonus had not completely resolved at discharge (follow up till day 10 from start of steroids) |
Noted cognitive decline: language difficulties, visual hallucination |
This study |
41, M |
Predominant right lower lung infiltrates |
10 days |
Generalised severe myoclonus predominantly proximal, involving limbs and trunk, present at rest and on action, auditory and tactile stimulus sensitivity present, truncal ataxia noted |
Noted moderate benefit with LEV and CLN |
Mild frontal dysfunction noted on detailed neuropsychology evaluation |
IVMP 1 g/day given for 5 days -continued to improve |