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L-5-hydroxytryptophan in treatment of several different syndromes in which myoclonus is prominent

From the Department of Neurology and the Laboratory of Clinical Neurophysiology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts.

The serotonin precursor L-5-hydroxytryptophan is useful therapy for patients with posthypoxic intention myoclonus. L-5-hydroxytryptophan plus carbidopa was administered to eight patients with this disorder or other syndromes in which myoclonus is prominent. This treatment (1) decreased the frequency of occurrence and amplitude of intention myoclonus in two patients with posthypoxic intention myoclonus and in one with idiopathic myoclonus, (2) had no effect in one patient with congenital encephalopathy and myoclonus, and (3) increased the frequency of occurrence and amplitude of myoclonus in two patients with lipid storage disease, one with myoclonic epilepsy, and in an additional patient with idiopathic myoclonus. Therefore, L-5-hydroxytryptophan does not effect improvement in all forms of myoclonus; it should be given with caution because it produces a high incidence of side effects. A patient's response to L-5-hydroxytryptophan therapy may be important in a diagnostic classification of myoclonic syndromes based on differences in indoleamine neurotransmitter function.

Requests for reprints should be addressed to Dr. Young, Massachusetts General Hospital, Boston, MA 02114. Dr. Growdon's present address is Department of Nutrition, Massachusetts Institute of Technology, Cambridge, MA.

This study was supported by the Parkinson's Disease Project of the Massachusetts General Hospital.

Received for publication February 10, 1976.

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