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Many drugs can induce myoclonus, including lithium, clozapine, penicillin, narcotics, anticonvulsants, anesthetics, calcium entry blockers, antihistamines, antineoplastic agents, levodopa, and bromocriptine.1
Here we describe three patients who, after receiving high doses of albuterol (salbutamol), developed acute multifocal myoclonic jerking.
Case 1.
A 56-year-old man with a history of diabetes, chronic alcoholism, and bronchial asthma had a cardiorespiratory arrest 5 years ago and was admitted to the intensive care unit for a severe asthmatic crisis. Despite treatment with high doses of salbutamol, the asthmatic crises were complicated by hypoxia, subsequent transient obtundation, and muscular jerks. After an additional episode of bronchial asthma, he was prescribed buccal spray instillations of salbutamol 50 mg/day and oral dexamethasone 40 mg/day for 5 days. After he received salbutamol for 2 days, the patient’s respiratory disorder had resolved, but he developed severe, stimulus-sensitive, multifocal jerking, superimposed on voluntary actions and postures (figure, A). Results of a cerebral MRI were normal, and, without other probable causes, treatment with salbutamol was discontinued. Improvement was observed in less than 48 hours, with the …
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