A nuanced view of post-anoxic myoclonus

Myoclonus after resuscitation from cardiac arrest is widelyviewed as an ominous finding. Based on this and several similar reports, the2006 guidelines from the American Academy of Neurology rec-ommended that the finding of early post-anoxic myoclonus wassufficient in isolation to accurately predict poor outcome andinform withdrawal of life-sustaining therapy. Subsequent evidence-based guidelineshave tempered this strong recommendation, making clear thatthe presence of myoclonus after cardiac arrest does not precludefavorable outcome A nuanced and precise understanding of post-anoxic myoclonusmay be hampered by complex taxonomy and clinical heterogene-ity. Terms like “myoclonus,” “status myoclonus” and “myoclonicstatus epilepticus” are used interchangeably in the literaturewithout consistent definitions. Early post-anoxic myoclonus should prompt EEG monitoring, not limitationor withdrawal of life-sustaining therapy.