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[Rhythmic skeletal myoclonus without palatal myoclonus].

I Moroo1, S Matsumoto, H Furumoto

  • 1Department of Neurology, Matsudo City Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|October 1, 1992
PubMed
Summary

This study describes rhythmic skeletal myoclonus in an elderly woman following a cerebral infarction. The condition, linked to cerebellar infarction, suggests a distinct mechanism from palatal myoclonus.

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Area of Science:

  • Neurology
  • Neuroscience
  • Cerebrovascular Diseases

Background:

  • Cerebral infarction can lead to various neurological deficits.
  • Myoclonus is an involuntary muscle twitching that can manifest in different forms.
  • Rhythmic skeletal myoclonus, particularly without palatal involvement, is rarely reported.

Observation:

  • An 89-year-old woman presented with rhythmic skeletal myoclonus primarily affecting the right upper limb, five days post-cerebral infarction.
  • The myoclonus occurred at rest and during posture but lessened with voluntary movement, worsening with emotional stress.
  • Surface electromyography showed a non-reciprocal pattern at approximately 3.5 Hz, distinct from intention tremor.

Findings:

  • Magnetic Resonance Imaging (MRI) revealed a small infarction in the right dentate nucleus and superior cerebellar peduncle, consistent with superior cerebellar artery territory infarction.

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  • The patient's myoclonus did not involve the palato-pharyngo-laryngo-oculo-diaphragmatic muscle group.
  • Onset of myoclonus occurred 5-15 days after cerebral infarction, a shorter interval than typically seen for intention tremor or palatal myoclonus.

    • Implications:

    • The specific location of the infarction (dentate nucleus and superior cerebellar peduncle) is crucial in understanding the etiology of this type of myoclonus.
    • The distinct timing and clinical presentation suggest that rhythmic skeletal myoclonus following cerebellar infarction may have a different pathophysiological mechanism compared to palatal myoclonus.
    • Further research into these specific cerebellar-related movement disorders is warranted to elucidate their underlying mechanisms and inform potential therapeutic strategies.