Effective high-dose clonazepam treatment in two patients with opsoclonus and myoclonus: GABA-ergic hypothesis
Abstrakt
Opsoclonus - myoclonus syndrome (OMS) is a very rare combination of symptoms usually associated with either malignancy or viral infection. The parainfectious manifestation is usually a self-limiting process.
We report on two young adults with OMS whose magnetic resonance imagings of the brain were normal. Single photon emission computed tomography showed reduced perfusion mainly in the right cerebellar hemisphere.
Initial treatment with corticosteroids did not accelerate recovery in patients. By contrast, clonazepam in higher doses (up to 12 mg/day) dramatically diminished neurological disability without any usual side-effects.
Moreover, symptoms of the patients were closely related to the dose of clonazepam. Clonazepam treatment to enhance GABA-ergic neurotransmission is an option in some OMS patients