EFFECT OF PIRACETAM ON MYOCLONUS SECONDARY TO ELECTROCUTION - A CASE-REPORT

After an accidental electrocution, a 36 year old man suffered a cardia c arrest for 5 minutes and was succesfully resuscitated. He subsequent ly developed spastic tetraparesis and spontaneous myoclonus in both up per limbs and the left leg, while neurological examination was otherwi se normal. Extensive laboratory investigation, including EEG, visual a nd brain scan auditory evoked responses, brain CT scan and cervical MR I, was unrevealing and somatosensory evoked potentials indicated findi ngs compatible with a high cervical lesion. Intravenous piracetam in h igh doses (24 g daily) progressively improved the involuntary movement s over a period of six weeks. However, myoclonic movements recurred th ree days after piracetam was discontinued and were almost abolished wh en the drug was re-introduced. Although it is known that piracetam eff ectively controls myoclonus secondary to post-anoxic brain injury and herpes encephalitis, to our knowledge, this is the first report of the drug's beneficial effect on myoclonus secondary to electrocution.