In the video of the month of March, a patient with generalized myoclonus is presented. Myoclonus consists of brisk movements, saccadic or gross muscular contractions and arrhythmias. It occurs more frequently in the face and proximal musculature.

In the adult, especially in the elderly patient, generalized myoclonus is usually secondary to acute metabolic disturbances associated with sepsis, liver encephalopathy, uremia, electrolyte imbalances (hyper - or hyponatremia, hyper - or hypocalcemia, hypomagnesiemia, hypophosphatemia), hypoglycemia, Wernicke’s encephalopathy, generalized cerebral ischemia, and in the postransplanted liver.

They should be differentiated from authentic myoclonic epileptic crisis and status myoclonus, for which EEG should be utilised.

In the case presented the cause was a complex metabolic alteration with kidney failure, sepsis and respiratory insufficiency that in the end was fatal.

Juan Ignacio Pérez Calvo
Servicio de Medicina Interna
Hospital Clínico Universitario "Lozano Blesa"
Zaragoza