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Myoclonus is a movement disorder characterized by sudden, brief, shocklike involuntary movements.1 The cause of myoclonus is broad, but within the hospital setting accidental or intentional overdose, anoxic–ischemic injury, and administration of anesthetic drugs or penicillin derivates should be considered first. Myoclonus has been linked with calcium channel blocking drugs, and one case has been reported with resolving “myoclonic dystonia” caused by verapamil.2 We present a patient with severe self-limiting, multifocal myoclonus after intentional verapamil overdose. Verapamil is a calcium ion influx inhibitor, which modulates ionic calcium in arterial smooth muscle and myocardial cells.3 Verapamil is generally a safe drug and there is less than 1% documented incidence of neurologic adverse effects.3
Case report.
A 61-year-old woman was admitted to the medical intensive care unit with profound hypotension, bradycardia, oligoanuria, and multifocal myoclonus. Her husband had been awoken during the night by the patient’s widespread, jerking movements. On arrival to an outside hospital, she had persistent …
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- Multifocal myoclonus due to verapamil overdose
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