Title

Chlormethiazole in the management of the opsoclonus-myoclonus syndrome

Author

Vilchez JJ; Lago A; Burguera JA; Yaya R; Casanova V

Address

Department of Neurology, University Hospital La Fe, Valencia, Spain

Source

J Int Med Res, 22(1):55-62 1994 Jan-Feb

Abstract

Two instances of successful treatment of the rare ocular dyskinesia, opsoclonus, with chlormethiazole are reported. A 65-year-old woman had the opsoclonus-myoclonus syndrome associated with carcinoma of the breast; her myoclonia and opsoclonus did not respond to intravenous diazepam or phenytoin. Treatment with intravenous chlormethiazole resulted in rapid control of her myoclonic attacks, followed by slower but complete resolution of the opsoclonus. Following control of the acute symptoms the patient was transferred to an oral chlormethiazole maintenance dose which was further reduced and subsequently discontinued after 5 months, when the patient's overall clinical status had improved. A 53-year-old man with opsoclonia, myoclonia, ataxia and encephalopathy, not associated with neoplasia, was given immunosuppressor drugs to establish basal control, and oral chlormethiazole for symptomatic treatment. Almost immediately after the initial dose of chlormethiazole the patient became more orientated; he was sedated and the agitation and myoclonic fits were brought under control quite quickly. The opsoclonus responded progressively and was completely resolved after a few days. The initial oral dose of chlormethiazole was gradually reduced and was discontinued after 5-6 months. Chlormethiazole was well tolerated; it may have an important role in the management of the rare opsoclonus-myoclonus syndrome.

Language

English

Unique Identifier

94244839

MESH Headings

Aged ; Breast Neoplasms CO ; Case Report ; Chlormethiazole *TU ; Female ; Human ; Male ; Middle Age ; Movement Disorders DT ; Myoclonus *DT ; Ocular Motility Disorders *DT ; Syndrome

Publication Type

JOURNAL  ARTICLE

ISSN

0300-0605

Country of Publication

ENGLAND

CAS Registry Number

533-45-9 (Chlormethiazole)