Mirror movements associated with cervical meningocele: case report

Area of Science:

• Neurology
• Neuroscience
• Medical Imaging

Background:

• Mirror movements, or synkinesis, are involuntary symmetrical movements of one limb that mirror voluntary movements of the contralateral limb.
• Cervical meningocele is a rare congenital condition involving protrusion of meninges through a defect in the cervical spine.
• Understanding the neuroanatomical basis of mirror movements is crucial for diagnosing and managing associated neurological disorders.

Observation:

• A patient presented with mirror movements associated with a diagnosed cervical meningocele.
• Magnetic Resonance Imaging (MRI) revealed a normal cerebrum and cervical meningocele, with an anomaly identified at the posterior junction of the cervical spinal cord and medulla.
• Transcranial magnetic stimulation (TMS) demonstrated abnormal bilateral responses in the thenar muscles following unilateral stimulation, differing significantly from typical responses.

Findings:

• The observed pattern of bilateral thenar muscle responses to unilateral TMS in this patient is atypical compared to normal subjects.
• The neuroimaging findings suggest a correlation between the cervical spinal cord-medulla junction anomaly and the presence of mirror movements.
• This case highlights a potential new etiological factor contributing to mirror movements.

Implications:

• The findings suggest that structural anomalies at the cervical spinal cord-medulla junction can be a cause of mirror movements.
• This case expands the known spectrum of etiological causes for mirror movements, aiding in differential diagnosis.
• Further research into spinal cord-brainstem interactions is warranted to fully elucidate the mechanisms underlying mirror movements in such cases.