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NEUROLOGY 1992;42:382
© 1992 American Academy of Neurology

Nicotine-sensitive paresis

T. Yokota, MD, Y. Kagamihara, MD, H. Hayashi, MD, H. Tsukagoshi, MD and H. Tanabe, MD

Department of Neurology (Drs. Yokota, Kagamihara, Hayashi, and Tanabe), Tokyo Metropolitan Neurological Hospital, and the Department of Neurology (Drs. Yokota and Tsukagoshi), Tokyo Medical and Dental University, Tokyo, Japan.

Immediately after a patient with myoclonus epilepsy smoked a nicotine-containing cigarette, tetra-paresis and hyperreflexia with ankle clonus developed, but disappeared within several minutes. During paresis, the H-reflex size of the soleus muscle increased, EEG showed more slow waves than before smoking, and the cerebral perfusion increased around the motor cortex as shown by single photon emission CT. A similar effect occurred when the patient chewed nicotine gum, and smoking a cigarette with a high nicotine content induced severe positive and negative myoclonus after the development of tetraparesis. Administration of the C6-type nicotinic antagonist mecamyl-amine not only countered the smoking effect, but ameliorated the spontaneous positive and negative myoclonus. Mecamylamine may prove useful for the treatment of positive and negative myoclonus in myoclonus epilepsy.

Address correspondence and reprint requests to Dr. Takanori Yokota, Department of Neurology, Tokyo Medical and Dental University, 1–5–45 Yushima, Bunkyo-ku, Tokyo 113, Japan.

Received February 25, 1991. Accepted for publication in final form July 12, 1991.






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