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Reticular Brainstem Myoclonus as A Symptom Post-Cardiac Arrest: A Case Report

I Gusti Agung Gede Ari Swanda, I Wayan Widyantara, Made Satria Yuda Dewangga, Made Agus Kresna Sucandra.


Abstract

Background: Improvements in cardiac arrest cannot reduce mortality and disability. Neurological disability or sequel that occurs can be in the form of cognitive and motor disorders. Report: A 66-year-old man with congested complaints diagnosed Acute Decompensated Heart Failure (ADHF) type C and intubated pneumonia due to respiratory failure. Two days of treatment, the patient experienced Atrial Fibrillation (AF) without a pulse, Ventricle Tachycardia (VT) / Ventricle Fibrillation (VF) asystole then Return of Spontaneous Circulation (ROSC). Post cardiac arrest of patients with Glasgow Coma Scale (GCS) 6 coma awareness accompanied by jerking movements several times, especially when touched in the distal extremity.Discussion: Patients with brief systemic circulation stops may experience cerebral ischemia-anoxia. Disorders that occur in the early phase after cardiac arrest is a decrease in a severe coma. Anoxic conditions can cause myoclonus. Myoclonus due to lesions in the brain stem includes exaggerated startle, reticular reflex myoclonus and palatal myoclonus or tremor. Conclusion: Reticular brainstem myoclonus as a neurological manifestation of post-cardiac arrest due to anoxia.

Key words: myoclonus, brainstem, anoxia, cardiac arrest






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