{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:00:46Z","timestamp":1782511246157,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,11]],"date-time":"2018-03-11T00:00:00Z","timestamp":1520726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Dutch Brain Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Posthypoxic myoclonus (<jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content>) in the first few days after resuscitation can be divided clinically into generalized and focal (uni\u2010 and multifocal) subtypes. The former is associated with a subcortical origin and poor prognosis in patients with postanoxic encephalopathy (<jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content>), and the latter with a cortical origin and better prognosis. However, use of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> as prognosticator in <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content> is hampered by the modest objectivity in its clinical assessment. Therefore, we aimed to obtain the anatomical origin of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> with use of neurophysiological investigations, and relate these to its clinical presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 20 patients (56 \u00b1 18 y\/o, 68% M, 2 survived, 1 excluded) with <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">EMG<\/jats:styled-content>\u2010video recording. Three neurologists classified <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> into generalized or focal <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content>. Anatomical origin (cortical\/subcortical) was assessed with basic and advanced neurophysiology (Jerk\u2010Locked Back Averaging, coherence analysis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinically assessed origin of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> did not match the result obtained with neurophysiology: cortical <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> was more likely present in generalized than in focal <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content>. In addition, some cases demonstrated co\u2010occurrence of cortical and subcortical myoclonus. Patients that recovered from <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content> had cortical myoclonus (1 generalized, 1 focal).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Hypoxic damage to variable cortical and subcortical areas in the brain may lead to mixed and varying clinical manifestations of myoclonus that differ of those patients with myoclonus generally encountered in the outpatient clinic. The current clinical classification of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> is not adequately refined to play a pivotal role in guiding treatment decisions to withdraw care. Our neurophysiological characterization of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> provides specific parameters to be used in designing future comprehensive studies addressing the potential role of <jats:styled-content style=\"fixed-case\">PHM<\/jats:styled-content> as prognosticator in <jats:styled-content style=\"fixed-case\">PAE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.514","type":"journal-article","created":{"date-parts":[[2018,3,11]],"date-time":"2018-03-11T05:08:40Z","timestamp":1520744920000},"page":"386-396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The interrelation between clinical presentation and neurophysiology of posthypoxic myoclonus"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3640-1503","authenticated-orcid":false,"given":"Jonathan C.","family":"van Zijl","sequence":"first","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Beudel","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bauke M.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joukje","family":"van der Naalt","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodi","family":"Zutt","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiete","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"},{"name":"Department of Clinical Neurophysiology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter M.","family":"van den Bergh","sequence":"additional","affiliation":[{"name":"Department of Critical Care University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Willem J.","family":"Elting","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"},{"name":"Department of Clinical Neurophysiology University Medical Center Groningen (UMCG) University of Groningen Hanzeplein 1 9700 RB Groningen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina A. 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