{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:18:02Z","timestamp":1790993882889,"version":"4.1.0"},"reference-count":30,"publisher":"Ubiquity Press, Ltd.","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TOHM"],"abstract":"<jats:p>Lance Adams Syndrome (LAS), or chronic post-hypoxic myoclonus (PHM), is a rare and disabling condition which occurs in the aftermath of a diffuse hypoxic brain injury, usually when patient regains consciousness. Due to its refractoriness to antiepileptics, deep brain stimulation (DBS) has been attempted over the past fifteen years.\nWe describe three patients who underwent Globus Pallidus interna (GPi)-DBS at the NYU Langone Department of Neurosurgery. Despite varying stimulation parameters and contact combinations, none achieved substantial improvement of action and negative myoclonus or regained the ability to ambulate unassisted.\nWe compared our results with previous reports. Our literature review identified ten cases of LAS treated with DBS since 2010. The target was GPi in 8\/10 patients, the ventralis intermedius (VIM) nucleus in one, and the subtalamic nucleus (STN) in one. Varying degrees of improvement were reported, with some evidence suggesting that long pulse width and lower frequency might be more effective. However, most reports provided only partial Unified Myoclonus Rating Scale (UMRS) scores, with missing information on rest and reflex myoclonus as well as negative myoclonus.\nDue to the paucity of prior reports and the limited generalizability of existing evidence, the efficacy of DBS in LAS has yet to be demonstrated. Further case reports, both positive and negative, supported by neurophysiological measures, may help bridge this knowledge gap.<\/jats:p>","DOI":"10.5334\/tohm.1171","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:03:57Z","timestamp":1783343037000},"page":"43","source":"Crossref","is-referenced-by-count":1,"title":["Post-Hypoxic Myoclonus and Deep Brain Stimulation. Experience from a Small Patient Cohort and Literature Review Highlighting Variable Outcomes"],"prefix":"10.5334","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7591-7428","authenticated-orcid":false,"given":"Tiziana","family":"De Santis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1493-0463","authenticated-orcid":false,"given":"Alon Y.","family":"Mogilner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5097-6998","authenticated-orcid":false,"given":"Michael","family":"Pourfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"issue":"1","key":"key20260707085939_B1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/1531-8257(200101)16:1<162::AID-MDS1029>3.0.CO;2-9","article-title":"Negative myoclonus in posthypoxic patients: historical note","volume":"16","year":"2001","journal-title":"Mov Disord"},{"issue":"6","key":"key20260707085939_B2","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1212\/WNL.57.6.1112","article-title":"A pilot tolerability and efficacy study of levetiracetam in patients with chronic myoclonus","volume":"57","year":"2001","journal-title":"Neurology"},{"issue":"Suppl 1","key":"key20260707085939_B3","first-page":"2","article-title":"The clinical spectrum of posthypoxic myoclonus","volume":"15","year":"2000","journal-title":"Mov Disord"},{"key":"key20260707085939_B4","article-title":"Post-hypoxic Myoclonus: Current Concepts, Neurophysiology, and Treatment","volume":"6","year":"2016","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"key20260707085939_B5","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.seizure.2019.03.003","article-title":"Improving post-hypoxic myoclonus using cannabidiol","volume":"67","year":"2019","journal-title":"Seizure"},{"issue":"2","key":"key20260707085939_B6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.14581\/jer.24016","article-title":"The Use of Perampanel in the Treatment of Lance-Adams Syndrome","volume":"14","year":"2024","journal-title":"J Epilepsy Res"},{"key":"key20260707085939_B7","article-title":"Increasing Evidence for the Use of Sodium Oxybate in Multi-Drug-Resistant Lance-Adams Syndrome","volume":"9","year":"2019","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"1","key":"key20260707085939_B8","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s12028-025-02307-z","article-title":"Treatment, Diagnostic Approach, and Long-Term Outcomes of Lance-Adams Syndrome","volume":"44","year":"2026","journal-title":"Neurocrit Care"},{"key":"key20260707085939_B9","article-title":"Lance-Adams Syndrome: An Updated Review of a Rare Post-Hypoxic Complication","volume":"15","year":"2025","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"5","key":"key20260707085939_B10","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1111\/ene.14737","article-title":"Long-term effects of pallidal and thalamic deep brain stimulation in myoclonus dystonia","volume":"28","year":"2021","journal-title":"Eur J Neurol"},{"issue":"1","key":"key20260707085939_B11","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s10143-019-01233-x","article-title":"Deep brain stimulation for myoclonus dystonia syndrome: a meta-analysis with individual patient data","volume":"44","year":"2021","journal-title":"Neurosurg Rev"},{"key":"key20260707085939_B12","article-title":"Treatment of Post-Hypoxic Myoclonus using Pallidal Deep Brain Stimulation Placed Using Interventional MRI Methods","volume":"10","year":"2020","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"4","key":"key20260707085939_B13","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1159\/000315464","article-title":"Thalamic deep brain stimulation for the treatment of action myoclonus caused by perinatal anoxia","volume":"88","year":"2010","journal-title":"Stereotact Funct Neurosurg"},{"issue":"14","key":"key20260707085939_B14","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1212\/WNL.0b013e31821482f4","article-title":"Gpi Pallidal Stimulation for Lance-Adams Syndrome","volume":"76","year":"2011","journal-title":"Neurology"},{"issue":"6","key":"key20260707085939_B15","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1007\/s00415-015-7748-x","article-title":"Alleviation of myoclonus after bilateral pallidal deep brain stimulation for Lance-Adams syndrome","volume":"262","year":"2015","journal-title":"J Neurol"},{"key":"key20260707085939_B16","doi-asserted-by":"crossref","first-page":"617","DOI":"10.54029\/2021ykj","article-title":"Is deep brain stimulation useful in Lance\u2013Adams syndrome?","volume":"26","author":"\u00d6zt\u00fcrk","year":"2021","journal-title":"Neurology Asia"},{"key":"key20260707085939_B17","article-title":"Treatment of refractory post-hypoxic myoclonus and focal epilepsy with subthalamic nuclei deep brain stimulation","volume":"127","year":"2024","journal-title":"Parkinsonism Relat Disord"},{"issue":"10","key":"key20260707085939_B18","article-title":"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","volume":"10","year":"2020","journal-title":"Brain Sci"},{"issue":"6","key":"key20260707085939_B19","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1159\/000509318","article-title":"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","volume":"98","year":"2020","journal-title":"Stereotact Funct Neurosurg"},{"key":"key20260707085939_B20","article-title":"Improvement of Post-hypoxic Myoclonus with Bilateral Pallidal Deep Brain Stimulation: A Case Report and Review of the Literature","volume":"7","year":"2017","journal-title":"Tremor Other Hyperk"},{"key":"key20260707085939_B21","article-title":"Deep Brain Stimulation for Post-Hypoxic Myoclonus: A Case Correlating Local Field Potentials to Clinical Outcome","volume":"15","year":"2025","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"4","key":"key20260707085939_B22","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1159\/000315464","article-title":"Thalamic Deep Brain Stimulation for the Treatment of Action Myoclonus Caused by Perinatal Anoxia","volume":"88","year":"2010","journal-title":"Stereot Funct Neuros"},{"issue":"1","key":"key20260707085939_B23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/mds.27474","article-title":"Long-term GPi-DBS improves motor features in myoclonus-dystonia and enhances social adjustment","volume":"34","year":"2019","journal-title":"Mov Disord"},{"issue":"13","key":"key20260707085939_B24","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1212\/01.wnl.0000297516.98574.c0","article-title":"Myoclonus-dystonia: clinical and electrophysiologic pattern related to SGCE mutations","volume":"70","year":"2008","journal-title":"Neurology"},{"key":"key20260707085939_B25","article-title":"IAPRD new consensus classification of myoclonus","volume":"132","year":"2025","journal-title":"Parkinsonism Relat Disord"},{"issue":"3","key":"key20260707085939_B26","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1136\/jnnp.40.3.253","article-title":"Reticular reflex myoclonus: a physiological type of human post-hypoxic myoclonus","volume":"40","year":"1977","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"11","key":"key20260707085939_B27","article-title":"Multimodal Assessment of the Origin of Myoclonus in Lance-Adams Syndrome","volume":"103","year":"2024","journal-title":"Neurology"},{"issue":"11","key":"key20260707085939_B28","article-title":"Lance-Adams Syndrome: It Really Comes From the Cortex!","volume":"103","year":"2024","journal-title":"Neurology"},{"issue":"3","key":"key20260707085939_B29","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1528-1167.2010.02884.x","article-title":"Chronic high-frequency deep-brain stimulation in progressive myoclonic epilepsy in adulthood\u2014report of five cases","volume":"52","year":"2011","journal-title":"Epilepsia"},{"issue":"3","key":"key20260707085939_B30","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1002\/(SICI)1097-4598(200003)23:3<321::AID-MUS3>3.0.CO;2-3","article-title":"Electrophysiological studies of myoclonus","volume":"23","year":"2000","journal-title":"Muscle Nerve"}],"container-title":["Tremor and Other Hyperkinetic Movements"],"original-title":[],"link":[{"URL":"https:\/\/tremorjournal.org\/articles\/1171\/files\/6a4cbfd5c1ad5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/tremorjournal.org\/articles\/1171\/files\/6a4cbfe816fd8.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/tremorjournal.org\/articles\/1171\/files\/6a4c09e4ae55a.zip","content-type":"application\/zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/tremorjournal.org\/articles\/1171\/files\/6a4cbfd5c1ad5.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:14:30Z","timestamp":1783415670000},"score":1,"resource":{"primary":{"URL":"https:\/\/tremorjournal.org\/articles\/10.5334\/tohm.1171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":30,"URL":"https:\/\/doi.org\/10.5334\/tohm.1171","relation":{},"ISSN":["2160-8288"],"issn-type":[{"value":"2160-8288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]}}}