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It can present as generalized, multifocal, or focal myoclonus and has traditionally been associated with poor prognosis. There are currently no standardized guidelines for its management, and prognostic outcomes remain variable. This review synthesizes the available evidence on clinical features, pathophysiology, diagnostic approach, and treatment of acute PHM. We reviewed 21 studies on PHM. Most patients experienced poor outcomes, including high rates of mortality or progression to persistent vegetative state, although a minority achieved recovery. Treatment remains largely empirical and variable, with benzodiazepines and antiseizure medications (e.g., levetiracetam, valproate, clonazepam, perampanel) being commonly used. No therapeutic intervention has consistently demonstrated improved long\u2010term neurological outcomes. We propose a possible treatment algorithm for PHM. Acute PHM is a clinically heterogeneous disorder with significant diagnostic and therapeutic challenges. Future research should focus on refining diagnostic criteria and identifying targeted therapies to improve outcomes in this often\u2010fatal condition.<\/jats:p>","DOI":"10.1111\/epi.70047","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T09:57:44Z","timestamp":1764842264000},"page":"1049-1065","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment approaches in posthypoxic myoclonus: A narrative review with expert opinion"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-3141","authenticated-orcid":false,"given":"Marina","family":"Romozzi","sequence":"first","affiliation":[{"name":"Dipartimento Universitario di Neuroscienze Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Neurologia, Unit\u00e0 Operativa Complesse, Dipartimento di Neuroscienze, Organi di Senso e Torace Fondazione Policlinico Universitario Agostino 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