Have a personal or library account? Click to login
Lance-Adams Syndrome: An Updated Review of a Rare Post-Hypoxic Complication Cover

Lance-Adams Syndrome: An Updated Review of a Rare Post-Hypoxic Complication

Tremor and Other Hyperkinetic Movements
Volume 15 (2025): Issue 1
By: Mohammad MalakootiORCID,  Afshin HeidariORCID,  Mahsa Motieian,  Armita FaridORCID,  Sina NeshatORCID,  Matin BidaresORCID,  Fatemeh JahanshahiORCID,  Milad GorganiORCID,  Hossein ShayestehyektaORCID,  Hazhir MoradiORCID and  Aydin ValipoorORCID  
Open Access
|Sep 2025

References

  1. 1Lance JW, Adams RD. The syndrome of intention or action myoclonus as a sequel to hypoxic encephalopathy. Brain. 1963;86:111–36. DOI: 10.1093/brain/86.1.111
    Back to article
  2. 2Caplan LR, Hurst JW, Chimowitz MI. Clinical Neurocardiology: Fundamentals and Clinical Cardiology. vol. 37. CRC Press; 1999. DOI: 10.1201/b14098
    Back to article
  3. 3English WA, Giffin NJ, Nolan JP. Myoclonus after cardiac arrest: pitfalls in diagnosis and prognosis. Anaesthesia. 2009;64:908–11. DOI: 10.1111/j.1365-2044.2009.05939.x
    Back to article
  4. 4Lee HL, Lee JK. Lance-adams syndrome. Ann Rehabil Med. 2011;35:939–43. DOI: 10.5535/arm.2011.35.6.939
    Back to article
  5. 5Freund B, Kaplan PW. Post-hypoxic myoclonus: Differentiating benign and malignant etiologies in diagnosis and prognosis. Clin Neurophysiol Pract. 2017;2:98–102. DOI: 10.1016/j.cnp.2017.03.003
    Back to article
  6. 6Ferlazzo E, Gasparini S, Cianci V, Cherubini A, Aguglia U. Serial MRI findings in brain anoxia leading to Lance-Adams syndrome: a case report. Neurol Sci. 2013;34:2047–50. DOI: 10.1007/s10072-013-1356-2
    Back to article
  7. 7Muddassir R, Idris A, Alshareef N, Khouj G, Alassiri R. Lance Adams Syndrome: A Rare Case Presentation of Myoclonus From Chronic Hypoxia Secondary to COVID-19 Infection. Cureus. 2021;13:e20321. DOI: 10.7759/cureus.20321
    Back to article
  8. 8Guo Y-R, Cao Q-D, Hong Z-S, Tan Y-Y, Chen S-D, Jin H-J, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil Med Res. 2020;7:11. DOI: 10.1186/s40779-020-00240-0
    Back to article
  9. 9Welsh JP, Placantonakis DG, Warsetsky SI, Marquez RG, Bernstein L, Aicher SA. The serotonin hypothesis of myoclonus from the perspective of neuronal rhythmicity. Adv Neurol. 2002;89:307–29.
    Back to article
  10. 10Scheibe F, Neumann WJ, Lange C, Scheel M, Furth C, Köhnlein M, et al. Movement disorders after hypoxic brain injury following cardiac arrest in adults. Eur J Neurol. 2020;27:1937–47. DOI: 10.1111/ene.14326
    Back to article
  11. 11Frucht SJ, Trost M, Ma Y, Eidelberg D. The metabolic topography of posthypoxic myoclonus. Neurology. 2004;62:1879–81. DOI: 10.1212/01.WNL.0000125336.05001.23
    Back to article
  12. 12Mure H, Toyoda N, Morigaki R, Fujita K, Takagi Y. Clinical Outcome and Intraoperative Neurophysiology of the Lance-Adams Syndrome Treated with Bilateral Deep Brain Stimulation of the Globus Pallidus Internus: A Case Report and Review of the Literature. Stereotact Funct Neurosurg. 2020;98:399–403. DOI: 10.1159/000509318
    Back to article
  13. 13Waddell A, Dirweesh A, Ordonez F, Kososky C, Reddy Peddareddygari L, Grewal RP. Lance-Adams syndrome associated with cerebellar pathology. J Community Hosp Intern Med Perspect. 2017;7:182–4. DOI: 10.1080/20009666.2017.1340730
    Back to article
  14. 14Zhang Y, Liu J, Jiang B, Liu H, Ding M, Song S, et al. Lance-Adams syndrome: a report of two cases. J Zhejiang Univ Sci B. 2007;8:715–20. DOI: 10.1631/jzus.2007.B0715
    Back to article
  15. 15Song J, Kang W, Ohn SH, Jung K-I, Bashir S, Yoo W-K. An Exploration of the Neural Network of Lance-Adams Syndrome: a Case Report. Brain Neurorehabil. 2021;14:e1. DOI: 10.12786/bn.2021.14.e1
    Back to article
  16. 16Yamaoka H, Tomemori N, Hayama K. The Lance-Adams syndrome following cardiopulmonary resuscitation: A report of two cases. J Anesth. 1994;8:349–51. DOI: 10.1007/BF02514665
    Back to article
  17. 17Janjua T, Moscote-Salazar L. Lance Adams Syndrome with Second Cardiac Arrest and Disappearance of Myoclonus. Electron J Biomed. 2022;1:49–53.
    Back to article
  18. 18Üdürgücü M, Aşilioğlu N, Çelik Ö, Eser S. Lance Adams Syndrome Following Post-Hypoxic Myoclonic Status Epilepticus In An Adolescent Patient With Chronic Renal Failure: A Case Report. J Exp Clin Med. 2021;38:379–80. DOI: 10.52142/omujecm.38.3.32
    Back to article
  19. 19Kim HS. A Case of Lance-Adams Syndrome Post Life-Threatening Bronchial Asthma. EMJ. 2019:71–6. DOI: 10.33590/emj/10313051
    Back to article
  20. 20Aicua Rapun I, Novy J, Solari D, Oddo M, Rossetti AO. Early Lance-Adams syndrome after cardiac arrest: Prevalence, time to return to awareness, and outcome in a large cohort. Resuscitation. 2017;115:169–72. DOI: 10.1016/j.resuscitation.2017.03.020
    Back to article
  21. 21Hajnsek S, Petelin Z, Malojcic B, Mijatovic D, Poljakovic Z, Basic S, et al. Lance-Adams syndrome in a patient with congenital coagulation factor XIII deficiency and spontaneous atypical subdural hematoma: case report. Neurologia Croatica. 2010;59:63–6.
    Back to article
  22. 22Ghosh R, Maity A, Biswas U, Das S, Benito-León J. Lance-Adams syndrome: An unusual complication of snakebite envenomation. Toxicon. 2022;209:50–5. DOI: 10.1016/j.toxicon.2022.02.008
    Back to article
  23. 23Ros-Castelló V, Quereda C, López-Sendón J, Corral I. Post-Hypoxic Myoclonus after COVID-19 Infection Recovery. Mov Disord Clin Pract. 2020;7:983–4. DOI: 10.1002/mdc3.13025
    Back to article
  24. 24Val-Jordan E, Gutierrez-Ibanes P, Bertol-Alegre V, Gurpegui-Puente M. Lance-Adams syndrome after infective endocarditis. Rev Neurol. 2017;64:479. DOI: 10.33588/rn.6410.2017075
    Back to article
  25. 25Amjed N, Cary LC. A Rare Case of Lance Adams Syndrome Post PEA Cardiac Arrest. Research and Reviews on Healthcare: Open Access Journal. 2021;6. DOI: 10.32474/RRHOAJ.2021.06.000238
    Back to article
  26. 26Boukobza M, Baud FJ, Malissin I, Mégarbane B. Lance-Adams syndrome and Parkinsonism with selective globi pallidi infarct following shock without cardiac arrest. Basal Ganglia. 2016;6:149–51. DOI: 10.1016/j.baga.2016.03.001
    Back to article
  27. 27Hahn A, Neubauer BA. Postanoxic myoclonus (Lance-Adams syndrome) after near-drowning. Neuropediatrics. 2011;42:VS04. DOI: 10.1055/s-0031-1273968
    Back to article
  28. 28Jain S, Jain M. Action myoclonus (Lance-Adam syndrome) secondary to strangulation with dramatic response to alcohol. Mov Disord. 1991;6:183. DOI: 10.1002/mds.870060219
    Back to article
  29. 29Krumholz A, Stern BJ, Weiss HD. Outcome from coma after cardiopulmonary resuscitation: relation to seizures and myoclonus. Neurology. 1988;38:401–5. DOI: 10.1212/WNL.38.3.401
    Back to article
  30. 30Elmer J, Rittenberger JC, Faro J, Molyneaux BJ, Popescu A, Callaway CW, et al. Clinically distinct electroencephalographic phenotypes of early myoclonus after cardiac arrest. Ann Neurol. 2016;80:175–84. DOI: 10.1002/ana.24697
    Back to article
  31. 31Lucas JM, Cocchi MN, Salciccioli J, Stanbridge JA, Geocadin RG, Herman ST, et al. Neurologic recovery after therapeutic hypothermia in patients with post-cardiac arrest myoclonus. Resuscitation. 2012;83:265–9. DOI: 10.1016/j.resuscitation.2011.09.017
    Back to article
  32. 32Rossetti AO, Rabinstein AA, Oddo M. Neurological prognostication of outcome in patients in coma after cardiac arrest. Lancet Neurol. 2016;15:597–609. DOI: 10.1016/S1474-4422(16)00015-6
    Back to article
  33. 33Seder DB, Sunde K, Rubertsson S, Mooney M, Stammet P, Riker RR, et al. Neurologic outcomes and postresuscitation care of patients with myoclonus following cardiac arrest. Crit Care Med. 2015;43:965–72. DOI: 10.1097/CCM.0000000000000880
    Back to article
  34. 34Tsetsou S, Novy J, Oddo M, Rossetti AO. EEG reactivity to pain in comatose patients: Importance of the stimulus type. Resuscitation. 2015;97:34–7. DOI: 10.1016/j.resuscitation.2015.09.380
    Back to article
  35. 35Oddo M, Rossetti AO. Early multimodal outcome prediction after cardiac arrest in patients treated with hypothermia. Crit Care Med. 2014;42:1340–7. DOI: 10.1097/CCM.0000000000000211
    Back to article
  36. 36Zhu J, Wang S, Xu X, Qi W. Lance-Adams syndrome: a case report and retrospective review. Int J Clin Exp Med. 2018;11:12752–7.
    Back to article
  37. 37Venkatesan A, Frucht S. Movement disorders after resuscitation from cardiac arrest. Neurol Clin. 2006;24:123–32. DOI: 10.1016/j.ncl.2005.11.001
    Back to article
  38. 38Pivik RT, Broughton RJ, Coppola R, Davidson RJ, Fox N, Nuwer MR. Guidelines for the recording and quantitative analysis of electroencephalographic activity in research contexts. Psychophysiology. 1993;30:547–58. DOI: 10.1111/j.1469-8986.1993.tb02081.x
    Back to article
  39. 39Werhahn KJ, Brown P, Thompson PD, Marsden CD. The clinical features and prognosis of chronic posthypoxic myoclonus. Mov Disord. 1997;12:216–20. DOI: 10.1002/mds.870120212
    Back to article
  40. 40Richardson MP, Grosse P, Allen PJ, Turner R, Brown P. BOLD correlates of EMG spectral density in cortical myoclonus: description of method and case report. Neuroimage. 2006;32:558–65. DOI: 10.1016/j.neuroimage.2006.04.183
    Back to article
  41. 41Arbelaez A, Castillo M, Mukherji SK. Diffusion-weighted MR imaging of global cerebral anoxia. AJNR Am J Neuroradiol. 1999;20:999–1007.
    Back to article
  42. 42Freund B, Sutter R, Kaplan PW. Lance-Adams Syndrome in the Pretargeted Temperature Management Era. Clin EEG Neurosci. 2017;48:130–8. DOI: 10.1177/1550059416643193
    Back to article
  43. 43van Zijl JC, Beudel M, vd Hoeven HJ, Lange F, Tijssen MAJ, Elting JWJ. Electroencephalographic Findings in Posthypoxic Myoclonus. J Intensive Care Med. 2016;31:270–5. DOI: 10.1177/0885066615571533
    Back to article
  44. 44Szczepańska A, Dziadkowiak E, Bladowska J, Kipiński L, Budrewicz S, Koszewicz M. The Usefulness of Quantitative EEG and Advanced MR Techniques in the Monitoring and Long-Term Prognosis of Lance-Adams Syndrome. Front Neurol. 2019;10:214. DOI: 10.3389/fneur.2019.00214
    Back to article
  45. 45Gupta HV, Caviness JN. Post-hypoxic Myoclonus: Current Concepts, Neurophysiology, and Treatment. Tremor Other Hyperkinet Mov (N Y). 2016.6:409. DOI: 10.5334/tohm.323
    Back to article
  46. 46Polesin A, Stern M. Post-anoxic myoclonus: a case presentation and review of management in the rehabilitation setting. Brain Inj. 2006;20:213–7. DOI: 10.1080/02699050500442972
    Back to article
  47. 47Frucht S, Fahn S. The clinical spectrum of posthypoxic myoclonus. Mov Disord. 2000;15(Suppl 1):2–7. DOI: 10.1002/mds.870150702
    Back to article
  48. 48Guo Y, Xiao Y, Chen L-F, Yin D-H, Wang R-D. Lance Adams syndrome: two cases report and literature review. J Int Med Res. 2022;50:3000605211059933. DOI: 10.1177/03000605211059933
    Back to article
  49. 49Saita D, Oishi S, Saito M. Administration of a small dose of perampanel improves walking ability in a case of Lance-Adams Syndrome. Psychiatry Clin Neurosci. 2022;76:89. DOI: 10.1111/pcn.13320
    Back to article
  50. 50Saito K, Oi K, Inaba A, Kobayashi M, Ikeda A, Wada Y. A case of the successful treatment of severe myoclonus with Lance-Adams syndrome by add-on perampanel showing long term effects. Rinsho Shinkeigaku. 2021;61:18–23. DOI: 10.5692/clinicalneurol.cn-001477
    Back to article
  51. 51Steinhoff BJ, Bacher M, Kurth C, Staack AM, Kornmeier R. Add-on perampanel in Lance-Adams syndrome. Epilepsy Behav Case Rep. 2016;6:28–9. DOI: 10.1016/j.ebcr.2016.05.001
    Back to article
  52. 52Lim S-Y, Jasti DB, Tan AH. Improvement of “Bouncy Gait” in Lance-Adams Syndrome with Perampanel. Cureus. 2020;12:e6773. DOI: 10.7759/cureus.6773
    Back to article
  53. 53Katsuki M, Narita N, Yasuda I, Tominaga T. Lance-Adams Syndrome Treated by Perampanel in the Acute Term. Cureus. 2021;13:e13761. DOI: 10.7759/cureus.13761
    Back to article
  54. 54Stubblefield K, Zahoor S, Sonmezturk H, Haas K, Mattingly D, Abou-Khalil B. Perampanel is effective against Lance-Adams syndrome. Epileptic Disord. 2021;23:769–71. DOI: 10.1684/epd.2021.1329
    Back to article
  55. 55Ramdhani RA, Frucht SJ, Kopell BH. Improvement of Post-hypoxic Myoclonus with Bilateral Pallidal Deep Brain Stimulation: A Case Report and Review of the Literature. Tremor Other Hyperkinet Mov (N Y). 2017.7:461. DOI: 10.5334/tohm.342
    Back to article
  56. 56Oi K, Neshige S, Hitomi T, Kobayashi K, Tojima M, Matsuhashi M, et al. Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex. Clin Neurophysiol. 2019;130:1804–12. DOI: 10.1016/j.clinph.2019.07.006
    Back to article
  57. 57Trinka E, Steinhoff BJ, Nikanorova M, Brodie MJ. Perampanel for focal epilepsy: insights from early clinical experience. Acta Neurol Scand. 2016;133:160–72. DOI: 10.1111/ane.12529
    Back to article
  58. 58Crespel A, Gelisse P, Tang NPL, Genton P. Perampanel in 12 patients with Unverricht-Lundborg disease. Epilepsia. 2017;58:543–7. DOI: 10.1111/epi.13662
    Back to article
  59. 59Hanada T, Hashizume Y, Tokuhara N, Takenaka O, Kohmura N, Ogasawara A, et al. Perampanel: a novel, orally active, noncompetitive AMPA-receptor antagonist that reduces seizure activity in rodent models of epilepsy. Epilepsia. 2011;52:1331–40. DOI: 10.1111/j.1528-1167.2011.03109.x
    Back to article
  60. 60Riboldi GM, Frucht SJ. Increasing Evidence for the Use of Sodium Oxybate in Multi-Drug-Resistant Lance-Adams Syndrome. Tremor Other Hyperkinet Mov (N Y). 2019.9. DOI: 10.5334/tohm.472
    Back to article
  61. 61Arpesella R, Dallocchio C, Arbasino C, Imberti R, Martinotti R, Frucht SJ. A patient with intractable posthypoxic myoclonus (Lance-Adams syndrome) treated with sodium oxybate. Anaesth Intensive Care. 2009;37:314–8. DOI: 10.1177/0310057X0903700214
    Back to article
  62. 62Zöllner JP, Noda AH, Rosenow F, Strzelczyk A. Improving post-hypoxic myoclonus using cannabidiol. Seizure. 2019;67:38–9. DOI: 10.1016/j.seizure.2019.03.003
    Back to article
  63. 63Rayadurg V, Muthuchellappan R, Rao U. Volatile anesthetic for the control of posthypoxic refractory myoclonic status. Indian J Crit Care Med. 2016;20(8):485–8. DOI: 10.4103/0972-5229.188208
    Back to article
  64. 64Ilik F, Kemal Ilik M, Cöven I. Levatiracetam for the management of Lance-Adams syndrome. Iran J Child Neurol. 2014;8(2):57–9.
    Back to article
  65. 65Božić K, Gebauer-Bukurov K, Sakalaš L, Divjak I, Ješić A. Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report. Vojnosanit Pregl. 2014;71(5):515–9. DOI: 10.2298/VSP1405515B
    Back to article
  66. 66Menon MK. Gamma-hydroxybutyrate in experimental myoclonus. Neurology. 1982;32(4):434–7. DOI: 10.1212/WNL.32.4.434
    Back to article
  67. 67Satoyoshi E, Kinoshita M, Takazawa Y, Yoda K. Case of intention myoclonus (Lance-Adams syndrome) and a dramatic effect of L-5-hydroxytryptophan. Rinsho Shinkeigaku. 1976;16(9):654–60.
    Back to article
  68. 68Hoshino A, Kumada S, Yokochi F, Hachiya Y, Hanafusa Y, Tomita S, et al. Effects of piracetam therapy in a case of Lance-Adams syndrome. No To Hattatsu. 2009;41(5):357–60.
    Back to article
  69. 69Coletti A, Mandelli A, Minoli G, Tredici G. Post-anoxic action myoclonus (Lance-Adams syndrome) treated with levodopa and GABAergic drugs. J Neurol. 1980;223(1):67–70. DOI: 10.1007/BF00313141
    Back to article
  70. 70Birthi P, Walters C, Ortiz Vargas O, Karandikar N. The use of intrathecal baclofen therapy for myoclonus in a patient with Lance Adams syndrome. Pm r. 2011;3(7):671–3. DOI: 10.1016/j.pmrj.2010.12.023
    Back to article
  71. 71Chandak R, Gudlavalleti A, Medin K. Refractory Myoclonus in Lance Adams Syndrome Responding to Brivaracetam (P6. 046). AAN Enterprises; 2018. DOI: 10.1212/WNL.90.15_supplement.P6.046
    Back to article
  72. 72Galldiks N, Timmermann L, Fink GR, Burghaus L. Posthypoxic myoclonus (Lance-Adams syndrome) treated with lacosamide. Clin Neuropharmacol. 2010;33(4):216–7. DOI: 10.1097/WNF.0b013e3181e1613f
    Back to article
  73. 73Rollinson RD, Gilligan BS. Postanoxic action myoclonus (Lance-Adams syndrome) responding to valproate. Arch Neurol. 1979;36(1):44–5. DOI: 10.1001/archneur.1979.00500370074019
    Back to article
  74. 74Wicklein EM, Schwendemann G. Use of clonazepam and valproate in patients with Lance Adams syndrome. J R Soc Med. 1993;86(10):618.
    Back to article
  75. 75Liron L, Chambost M, Depierre P, Peillon D, Combe C. Effectiveness of valproic acid for postanoxic action myoclonus (Lance-Adams syndrome). Ann Fr Anesth Reanim. 1998;17(10):1247–9. DOI: 10.1016/S0750-7658(99)80033-1
    Back to article
  76. 76Kim MJ, Park SH, Heo K, Chang JW, Kim JI, Chang WS. Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission. Brain Sci. 2020;10(10). DOI: 10.3390/brainsci10100730
    Back to article
  77. 77Gao F, Ostrem JL, Wang DD. Treatment of Post-Hypoxic Myoclonus using Pallidal Deep Brain Stimulation Placed Using Interventional MRI Methods. Tremor Other Hyperkinet Mov (N Y). 2020.10:42. DOI: 10.5334/tohm.544
    Back to article
  78. 78Asahi T, Kashiwazaki D, Dougu N, Oyama G, Takashima S, Tanaka K, et al. Alleviation of myoclonus after bilateral pallidal deep brain stimulation for Lance-Adams syndrome. J Neurol. 2015;262(6):1581–3. DOI: 10.1007/s00415-015-7748-x
    Back to article
  79. 79Öztürk G, Taşçı İ, Samancı MY, Peker S. Is deep brain stimulation useful in Lance–Adams syndrome? 2021. DOI: 10.54029/2021ykj
    Back to article
  80. 80Jones HN, Donovan NJ, Sapienza CM, Shrivastav R, Fernandez HH, Rosenbek JC. Expiratory muscle strength training in the treatment of mixed dysarthria in a patient with Lance-Adams syndrome. Journal of Medical Speech Language Pathology. 2006;14(3):207.
    Back to article
DOI: https://doi.org/10.5334/tohm.1074 | Journal eISSN: 2160-8288
Journal RSS Feed
Language: English
Submitted on: Jul 11, 2025
Accepted on: Sep 14, 2025
Published on: Sep 24, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
Lance-Adams Syndrome,
Post-Hypoxic Myoclonus,
Myoclonus,
Cardiopulmonary Resuscitation

© 2025 Mohammad Malakooti, Afshin Heidari, Mahsa Motieian, Armita Farid, Sina Neshat, Matin Bidares, Fatemeh Jahanshahi, Milad Gorgani, Hossein Shayestehyekta, Hazhir Moradi, Aydin Valipoor, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Previous articleVolume 15 (2025): Issue 1Next article