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Neuromyotonia is a rare complication of radiation therapy.1 Most reported cases involve oculomotor muscles1,2 and occur months to decades after radiation therapy. Neuromyotonia is characterized by transient involuntary tonic contractions, which occur either spontaneously or are triggered by movements, with delayed relaxation of affected muscles.3,–,5 We report 2 cases of postirradiation neuromyotonia of the spinal accessory nerve.
Level of evidence.
This study provides Class IV evidence that carbamazepine is effective in controlling the involuntary muscle contractions for patients with postradiation neuromyotonia of the SCM.
Patients.
A 68-year-old man had spasms of the left sternocleidomastoid muscle (SCM) with involuntary head movements (see video on the Neurology® Web site at www.neurology.org). He had a history of chronic obstructive pulmonary disease, hypertension, and an endarterectomy of the right internal carotid artery. In 2002, an epidermoid carcinoma of the vocal cord (T1N0M0) was diagnosed and treated by surgery and conventional fractionated radiation therapy. Radiation therapy was performed from February to April 2002 (a total dose of 70 Gy in 35 fractions). The patient …
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