This is a late preterm, 36 1/7 gestational weeks, admitted to the neonatal intensive care unit for severe renal dysplasia secondary to obstructive uropathy, and pulmonary hypoplasia complicated with pulmonary hypertension. On the 12th day of life, sedation with lorazepam 0.1 mg/kg was administered in preparation for an invasive procedure. The baby immediately started to experience generalized myoclonus ([Video 1—Part A]). On suspicion of an epileptic origin, phenobarbital 20 mg/kg was administered, with no success. Cranial ultrasound revealed no bleeding, while electroencephalography showed no epileptiform discharges ([Fig. 1]). Suspecting benzodiazepine-induced myoclonus, flumazenil at 0.01 mg/kg was administered, resulting in cessation of movements in around 15 minutes ([Video 1—Part B]). Myoclonus has been reported in neonates after benzodiazepine administration.[1] [2] [3] This phenomenon seems to stem from the developmental activity of the GABA receptor, potentially heightening the vulnerability of preterm infants.[2] The cessation of movements after flumazenil has been documented in just two other cases.[1] [2] Our case provides videographic documentation, enhancing understanding of benzodiazepine-induced myoclonus in neonates.

Video 1 In the first part, generalized myoclonias are observed following the administration of lorazepam. The second part shows cessation of abnormal movements following administration of flumazenil.