Table 33.15
Toxic and drug-induced myoclonus
AgentComment

Bismuth

See text

Methylbromide

See text

Toxic cooking oil

See text

Oven cleaner

Peatfield and Boothman 1991

Organic and inorganic mercury

Snyder 1972, Roullet et al. 1984

Lead benzine

Bini and Bollea 1974

Gasoline sniffing

Hansen and Sharp 1978, Valpey et al. 1978, Goodheart and Dunne 1994

Plastic explosives

Ketel and Hughes 1972

Chloralose

Moene et al. 1969

Chlorinated hydrocarbon pesticides

Dorndorf et al. 1975, Garrettson et al. 1984

Strychnine

Stimulus-sensitive

Tetanus

See Chapter 20

Water-soluble contrast media

Junck and Marshall 1983, Rivera et al. 1995, Killeffer and Kaufman 1997

Generally segmental. Starts in legs and ascends if used inadvertently for myelography

Anaesthetics

See text

Levodopa

See text and Chapter 5

Dopamine receptor blockers

Tardive myoclonus – see text and Chapter 23. Myoclonus may also occur as part of acute dystonic reaction (Ritchie et al. 1988)

Antidepressants

Tricyclics

Lejoyeux et al. 1992

Monoamine oxidase inhibitors

Lieberman et al. 1986, Remick et al. 1989

Selective serotonin reuptake inhibitors

As part of the serotonin syndrome – Bodner et al. 1995, Lane and Baldwin 1997

Lithium

Rosen and Stevens 1983, Takahashi et al. 1997, Evidente and Caviness 1999

NMDA-antagonist Memantine

Moellentin et al. 2008

Adrenergic blockers/antimicrobials (toxicity)

Fernandez and Friedman 1999

Penicillins

Especially if renal impairment – Lerner et al. 1967

Cephalosporins

Especially if renal impairment – Klion et al. 1994, Herishanu et al. 1998

Acyclovir

Especially if renal impairment – Guilhem et al. 1991, Leikin et al. 1995

Piperazine

Given for worms – Kompf and Neundorfer 1974, Drouet and Valance 1994

Anticonvulsants (toxicity)

Genton et al. 1998 and see ‘Asterixis’ in text

Chlorambucil

Byrne et al. 1981, Vandenberg et al. 1988, Wyllie et al. 1997

Cholinesterase inhibitors

Abilleira et al. 1998

Methaqualone

Abboud et al. 1974, Faught 1986, Kurz et al. 1995

Diclofenac

Ammenti et al. 1980, Sanchez Valiente 1995

Marijuana

Feeney et al. 1975

Opiates

Oral, parenteral, or epidural/intrathecal – De Conno et al. 1991, Radbruch et al. 1997, Mercadante 1998

Alcohol

Bartolomei et al. 1996

Opiate, benzodiaepine, and alcohol withdrawal

Myoclonic jerks commonly seen as part of withdrawal syndrome

AgentComment

Bismuth

See text

Methylbromide

See text

Toxic cooking oil

See text

Oven cleaner

Peatfield and Boothman 1991

Organic and inorganic mercury

Snyder 1972, Roullet et al. 1984

Lead benzine

Bini and Bollea 1974

Gasoline sniffing

Hansen and Sharp 1978, Valpey et al. 1978, Goodheart and Dunne 1994

Plastic explosives

Ketel and Hughes 1972

Chloralose

Moene et al. 1969

Chlorinated hydrocarbon pesticides

Dorndorf et al. 1975, Garrettson et al. 1984

Strychnine

Stimulus-sensitive

Tetanus

See Chapter 20

Water-soluble contrast media

Junck and Marshall 1983, Rivera et al. 1995, Killeffer and Kaufman 1997

Generally segmental. Starts in legs and ascends if used inadvertently for myelography

Anaesthetics

See text

Levodopa

See text and Chapter 5

Dopamine receptor blockers

Tardive myoclonus – see text and Chapter 23. Myoclonus may also occur as part of acute dystonic reaction (Ritchie et al. 1988)

Antidepressants

Tricyclics

Lejoyeux et al. 1992

Monoamine oxidase inhibitors

Lieberman et al. 1986, Remick et al. 1989

Selective serotonin reuptake inhibitors

As part of the serotonin syndrome – Bodner et al. 1995, Lane and Baldwin 1997

Lithium

Rosen and Stevens 1983, Takahashi et al. 1997, Evidente and Caviness 1999

NMDA-antagonist Memantine

Moellentin et al. 2008

Adrenergic blockers/antimicrobials (toxicity)

Fernandez and Friedman 1999

Penicillins

Especially if renal impairment – Lerner et al. 1967

Cephalosporins

Especially if renal impairment – Klion et al. 1994, Herishanu et al. 1998

Acyclovir

Especially if renal impairment – Guilhem et al. 1991, Leikin et al. 1995

Piperazine

Given for worms – Kompf and Neundorfer 1974, Drouet and Valance 1994

Anticonvulsants (toxicity)

Genton et al. 1998 and see ‘Asterixis’ in text

Chlorambucil

Byrne et al. 1981, Vandenberg et al. 1988, Wyllie et al. 1997

Cholinesterase inhibitors

Abilleira et al. 1998

Methaqualone

Abboud et al. 1974, Faught 1986, Kurz et al. 1995

Diclofenac

Ammenti et al. 1980, Sanchez Valiente 1995

Marijuana

Feeney et al. 1975

Opiates

Oral, parenteral, or epidural/intrathecal – De Conno et al. 1991, Radbruch et al. 1997, Mercadante 1998

Alcohol

Bartolomei et al. 1996

Opiate, benzodiaepine, and alcohol withdrawal

Myoclonic jerks commonly seen as part of withdrawal syndrome

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