Postsurgical cortical myoclonus responsive to perampanel

An infrequent and difficult to treat complication of the neurosurgical removal of a lesion in the frontal or parietal lobes is cortical myoclonus (CM).1,2 CM has also been linked to focal lesions in the same locations independently from their surgical removal.3-5 In the present case and in the majority of the reported cases, the paramedian premotor cortex was involved. However, all except one of the lesions that were previously reported were not adjacent to the primary motor cortex as in our patient (figure, A). Treatment of myoclonus can be difficult and polytherapy is often required for an acceptable result.6 We present a case of CM that started 5 days after surgery, was not responsive to benzodiazepine and levetiracetam, and resolved only after perampanel administration.