Hemicrania continua: Indomethacin induced myoclonus

• Published in: Clinical neurology and neurosurgery Vol. 206; p. 106703
• Main Authors: Chan, Tommy Lik Hang, Hindiyeh, Nada
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2021; Elsevier Limited
• Subjects: Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Drug dosages; Drug-induced myoclonus; Headaches; Hemicrania continua; Humans; Indomethacin; Indomethacin - adverse effects; Inflammation; Male; Middle Aged; Migraine Disorders - drug therapy; Movement disorders; Myoclonus; Myoclonus - chemically induced; Narcotics; Neurology; Neurosurgery; Nonsteroidal anti-inflammatory drugs; γ-Aminobutyric acid; Drug-induced myoclonus; Myoclonus; NSAIDs; GABA; CNS; Indomethacin; Hemicrania continua; gamma-Aminobutyric acid; non-steroidal anti-inflammatory drugs; central nervous system
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2021.106703

Myoclonus has been described rarely as an adverse effect with some non-steroidal anti-inflammatory drugs, but never with indomethacin. Indomethacin is a common nonsteroidal anti-inflammatory drug used for various primary headache disorders, including hemicrania continua. We present a rare case of a 45-year-old male with hemicrania continua who developed myoclonus from indomethacin. These movements resolved completely following discontinuation of indomethacin. The disturbance on the serotonergic and GABAergic systems may be associated with indomethacin induced myoclonus. Clinicians and patients should be mindful with this potential side effect with indomethacin. •Indomethacin is a common non-steroidal anti-inflammatory drug used for various primary headache disorders.•Drug-induced myoclonus has never been described with the use of indomethacin.•The serotonergic and GABAergic systems are involved in the pathophysiology of myoclonus.•Increased serotonergic transmission may be involved in the induction of myoclonus.•Indomethacin can inhibit GABA reuptake.