[A case of cortical reflex myoclonus manifesting tremor]

A 58-year-old woman developed slowly progressive tremulous myoclonus provoked mainly by action and posture. She had neither seizure nor dementia. No one in her family had similar symptoms. The presence of giant somatosensory evoked potentials (SEP) with enhanced long loop reflex and premovement cortical spikes demonstrated by the jerk-locked averaging method suggest that the involuntary movement is cortical reflex myoclonus. Magnetoencephalogram revealed that the generator sources of giant SEPs were the post-central somatosensory cortex and probably also the pre-central motor cortex. Symptoms improved after treatment with zonisamide, clonazepam and valpolate. This kind of involuntary movement might be called cortical myoclonic tremor.