1
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Gurru P, Bajaj K, Lal M. Chronic Abdominal Myoclonus Controlled with Prednisone Therapy: A Case Report. Cureus 2023; 15:e44178. [PMID: 37645662 PMCID: PMC10461779 DOI: 10.7759/cureus.44178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 08/31/2023] Open
Abstract
Abdominal myoclonus may manifest as involuntary, repetitive contractions of the abdominal wall due to a variety of neurologic pathologies. There are, however, limited cases reporting abdominal wall myoclonus without any clear neurologic etiologies. Here we present a case of a 72-year-old male with a history of rheumatoid arthritis, asthma, obstructive sleep apnea (OSA), and restless leg syndrome who presented with chronic, involuntary, repetitive contractions of his abdomen without any spinal or extremity involvement. His extensive neurologic and secondary systematic workup was negative, and he had a limited response to several different medication trials. The patient's abdominal myoclonus, however, was better controlled with the administration of prednisone.
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Affiliation(s)
| | - Kelash Bajaj
- Hematology and Oncology, Texas Tech University Health Science Center, Odessa, USA
| | - Manoher Lal
- Neurology, Advanced Neuroscience Clinic, Midland, USA
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2
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Colucci F, Carvalho V, Gonzalez-Robles C, Bhatia KP, Mulroy E. From Collar to Coccyx: Truncal Movement Disorders: A Clinical Review. Mov Disord Clin Pract 2021; 8:1027-1033. [PMID: 34631937 DOI: 10.1002/mdc3.13325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 12/25/2022] Open
Abstract
Background Movement disorders affecting the trunk remain a diagnostic challenge even for experienced clinicians. However, despite being common and debilitating, truncal movement disorders are rarely discussed and poorly reviewed in the medical literature. Objectives To review common movement disorders affecting the trunk and provide an approach for clinicians based on the truncal region involved (shoulder, chest, diaphragm, abdomen, pelvis, and axial disorders). For each disorder, clinical presentation, etiologic differential diagnosis, and "clinical clues" are discussed. Conclusion This review provides a clinically focused, practical approach to truncal movement disorders, which will be helpful for physicians in everyday practice.
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Affiliation(s)
- Fabiana Colucci
- Clinical and Biological Sciences Department, Neurology Unit San Luigi Gonzaga Hospital Turin Italy
| | - Vanessa Carvalho
- Department of Neurology Hospital Pedro Hispano/Unidade Local de Saúde de Matosinhos Matosinhos Portugal
| | - Cristina Gonzalez-Robles
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Eoin Mulroy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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3
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Cecchi I, Radin M, Rubini E, Foddai SG, Barinotti A, Roccatello D, Sciascia S. Clinical manifestations in patients with antiphospholipid antibodies: Beyond thrombosis and pregnancy loss. Lupus 2021; 30:884-892. [PMID: 33593163 DOI: 10.1177/0961203321995248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The clinical spectrum of the antiphospholipid syndrome (APS) encompasses additional manifestations other than thrombosis and pregnancy morbidity, which may potentially affect every organ and system. The pathophysiology of APS indeed cannot be explained exclusively by a prothrombotic state and the "extra-criteria" manifestations of the syndrome should be attributed to other mechanisms, such as inflammation, complement and platelet activation. In this case-series, we report patients with uncommon clinical APS presentations, to highlight relevant peculiarities of the syndrome, potentially paving the way for a further update of clinical as well as laboratory manifestations of this complex immunological condition.
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Affiliation(s)
- Irene Cecchi
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Massimo Radin
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Elena Rubini
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Silvia G Foddai
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, Turin, Italy
| | - Alice Barinotti
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Department of Clinical and Biological Sciences, School of Specialization of Clinical Pathology, University of Turin, Turin, Italy
| | - Dario Roccatello
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Turin, Italy
| | - Savino Sciascia
- Center of Research of Immunopathology and Rare Diseases - Coordinating Center of Piemonte and Aosta Valley Network for Rare Diseases, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.,Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Turin, Italy
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4
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Yang X, Li H, Hallett M, Wan X, Wu Y. Scar Dancing Syndrome: Peripheral Trauma Induced Involuntary Hyperkinesia around Surgical Incision. Mov Disord Clin Pract 2021; 8:267-272. [PMID: 33816653 DOI: 10.1002/mdc3.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 11/09/2022] Open
Abstract
Background Peripherally induced movement disorders represent a rare and debated complication of peripheral trauma. It is difficult to determine a causal relationship between peripheral injuries and subsequent movement disorders. Cases Here, we introduce and characterize four patients with post-surgical scar-associated movement disorders, a peripherally-induced rippling movement disorder confined to the muscles just under a long surgical incision scar, appearing weeks to months after surgery. This novel 'scar dancing' syndrome does not spread to adjacent muscles and persists during sleep. Conclusion Scar dancing syndrome expands the phenotypic spectrum of peripherally induced movement disorders, in which movement disorder is confined to a long surgical incision site.
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Affiliation(s)
- Xiaodong Yang
- Department of Neurology & Institute of Neurology Ruijin Hospital, Affiliated with Shanghai Jiaotong University School of Medicine Shanghai China
| | - Hongxia Li
- Department of Neurology & Institute of Neurology Ruijin Hospital, Affiliated with Shanghai Jiaotong University School of Medicine Shanghai China
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA
| | - Xinhua Wan
- Department of Neurology Peking Union Medical College Hospital Beijing China
| | - Yiwen Wu
- Department of Neurology & Institute of Neurology Ruijin Hospital, Affiliated with Shanghai Jiaotong University School of Medicine Shanghai China
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5
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Successful Treatment of Auricular Dystonia by Unilateral Pallidothalamic Tractotomy. Tremor Other Hyperkinet Mov (N Y) 2021; 11:4. [PMID: 33552671 PMCID: PMC7824976 DOI: 10.5334/tohm.579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Ear movement disorders are rarely reported. Although some patients may respond to botulinum toxin injections, reports on surgical treatment options remain limited. Case Report: A 57-year-old woman was diagnosed with auricular dystonia, which was refractory to botulinum toxin injections. Since involuntary movement and pain were predominantly present on the right side and the patient rejected the implantation of a mechanical device, we decided to perform left pallidothalamic tractotomy. Immediately following lesioning, bilateral ear movements and right auricular pain ceased with no complications. Discussion: Stereotactic neurosurgical treatment can be an alternative for auricular dystonia. Highlights: Ear movement disorders, such as auricular myoclonus or dystonia, are rarely reported. The present case was refractory to repetitive botulinum toxin injections and oral medications. To the best of our knowledge, this is the first case of auricular dystonia that successfully improved with stereotactic neurosurgical treatment (pallidothalamic tractotomy).
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6
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Lizarraga KJ, Thompson PD, Moore HP, Mizraji G, Gershanik OS, Singer C, Lang AE. Dancing Dorsal Quadrilaterals: A Novel Peripherally Induced Movement Disorder. JAMA Neurol 2020; 76:351-354. [PMID: 30556833 DOI: 10.1001/jamaneurol.2018.3948] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Recognized peripherally induced movement disorders include the painful legs moving toes syndrome, postamputation dyskinesias, and belly dancer dyskinesias. Objective To introduce and characterize the dancing dorsal quadrilaterals, a novel peripherally induced movement disorder that predominantly affects dorsal quadrilateral muscles (trapezius and rhomboids) after upper spine instrumentation. Design, Setting, and Participants Between 1990 and 2015, a total of 4 patients who developed abnormal movements of the dorsal quadrilateral muscles after upper spine instrumentation were referred to movement disorders clinics at 3 academic medical centers in the United States, Canada, and Argentina. A prospective and retrospective analysis of the clinical and electrophysiologic characteristics of their abnormal movements is presented in this brief report. Data were analyzed between July 2015 and January 2018. Exposures Extensive upper spine instrumentation complicated with misalignment and prolonged postsurgical neuropathic pain. Main Outcomes and Measures Video documentation of clinical and electrophysiologic characteristics of dancing dorsal quadrilaterals. Results Four patients with upper spine disease (2 women and 2 men, ranging in age from early 30s to early 70s) required extensive surgical manipulation and instrumentation that was complicated by misalignment, prolonged dorsal neuropathic pain, and unusual abnormal movements. These movements consisted of semirhythmic, repetitive writhing, and jerky movements of the scapular region with distinctive rotatory motions. They are referred to as the dancing dorsal quadrilaterals because they predominantly affected the bilateral trapezius and rhomboids (dorsal quadrilateral muscles) but could spread to adjacent muscles, and they are similar in appearance and possibly pathogenesis to "belly dancer" dyskinetic movements. The movements of the dancing dorsal quadrilaterals occur when upright but not when lying down or during voluntary muscle activation. Sensory stimulation also diminishes the movements. Long-duration bursts of normal motor unit potentials with normal recruitment pattern were evidenced. Conclusions and Relevance The dancing dorsal quadrilaterals syndrome represents a further example of a peripherally induced movement disorder characterized by neuropathic pain preceding a regional movement disorder following soft-tissue or nerve injury.
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Affiliation(s)
- Karlo J Lizarraga
- Jackson Memorial Hospital, Department of Neurology, University of Miami School of Medicine, Miami, Florida.,The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Philip D Thompson
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Henry P Moore
- Jackson Memorial Hospital, Department of Neurology, University of Miami School of Medicine, Miami, Florida
| | - Gabriel Mizraji
- Institute of Neuroscience, Favaloro University Hospital, Buenos Aires, Argentina
| | - Oscar S Gershanik
- Institute of Neuroscience, Favaloro University Hospital, Buenos Aires, Argentina
| | - Carlos Singer
- Jackson Memorial Hospital, Department of Neurology, University of Miami School of Medicine, Miami, Florida
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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7
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Elavarasi A, Goyal V, Samal P. Dancing Scapula: The Missed Movement. Ann Indian Acad Neurol 2019; 22:218-219. [PMID: 31007439 PMCID: PMC6472239 DOI: 10.4103/aian.aian_210_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Samal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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8
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Klimkowicz-Mrowiec A, Kasprzyk-Galon K, Barbano R. Isolated hemifacial spasm presenting as unilateral, involuntary ear movements. Parkinsonism Relat Disord 2018; 49:106-107. [DOI: 10.1016/j.parkreldis.2018.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/25/2017] [Accepted: 01/03/2018] [Indexed: 11/26/2022]
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9
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López-Blanco R, Monroy-Diaz M, Méndez-Guerrero A, Hijosa M, Sánchez-Villacañas JRA, de Lucas FG, Miranda-Mayordomo M, Alonso-Ortiz A. Involuntary, slow, rhythmic movements of the shoulder girdle after scapular surgery: Shoulder girdle dyskinesia. Parkinsonism Relat Disord 2018. [PMID: 29519584 DOI: 10.1016/j.parkreldis.2018.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Roberto López-Blanco
- Department of Neurology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain; Healthcare Research Institute of Hospital Universitario 12 de Octubre (i+12), Madrid, Spain.
| | - Monica Monroy-Diaz
- Department of Neurophysiology, Hospital FREMAP Majadahonda, Madrid, Spain.
| | - Antonio Méndez-Guerrero
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain; Movement Disorders Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - Milagros Hijosa
- Department of Neurophysiology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain.
| | | | | | | | - Ana Alonso-Ortiz
- Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain; Neuromuscular Diseases Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
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10
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Alshubaili A, Abou-Al-Shaar H, Santhamoorthy P, Attia H, Bohlega S. Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer's dyskinesia. BMC Neurol 2016; 16:226. [PMID: 27855646 PMCID: PMC5114732 DOI: 10.1186/s12883-016-0746-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/08/2016] [Indexed: 11/29/2022] Open
Abstract
Background Belly dancer’s dyskinesia is an extremely rare condition. It manifests as semicontinuous, slow, writhing, sinuous abdominal wall movements that are bothersome to the patient. Management of this condition is extremely difficult and challenging. Methods We describe four patients with belly dancer’s dyskinesia who were treated with Botulinum Toxin A (BTX) injections under ultrasound guidance. Results All patients underwent the same BTX injection procedure using an aseptic technique under ultrasound guidance. The patients responded well to the BTX injections after an unsatisfactory course of medical treatment. The patients reported complete abolishment of abnormal abdominal movements with no side effects. Conclusions We report a cohort of patients with belly dancer dyskinesia treated successfully with BTX injections. Ultrasound guidance for injections increases the accuracy and reduces the risk of the complications. BTX injection under ultrasound guidance is a safe and effective treatment modality that should be employed as a first-line in the management of patients with belly dancer’s dyskinesia. Electronic supplementary material The online version of this article (doi:10.1186/s12883-016-0746-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hussam Abou-Al-Shaar
- Movement Disorder Program, Division of Neurology, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Hosam Attia
- Department of Radiology, Ibn Sina Hospital, Kuwait, Kuwait
| | - Saeed Bohlega
- Movement Disorder Program, Division of Neurology, Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. .,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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11
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Camacho A, Núñez N, Armangué T, Simón R. Myorhythmia-Like Dyskinesia Affecting the Face and Ear Associated With Anti- N-Methyl-d-Aspartate Receptor Encephalitis. Mov Disord Clin Pract 2015; 3:425-426. [PMID: 30713936 DOI: 10.1002/mdc3.12300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/26/2015] [Accepted: 10/29/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ana Camacho
- Child Neurology Unit Department of Neurology Hospital Universitario 12 de Octubre Facultad de Medicina Universidad Complutense Madrid Spain
| | - Noemí Núñez
- Child Neurology Unit Department of Neurology Hospital Universitario 12 de Octubre Facultad de Medicina Universidad Complutense Madrid Spain
| | - Thaís Armangué
- Neuroimmunology Program Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Spain.,Department of Neurology Hospital Clinic Universitat de Barcelona Barcelona Spain
| | - Rogelio Simón
- Child Neurology Unit Department of Neurology Hospital Universitario 12 de Octubre Facultad de Medicina Universidad Complutense Madrid Spain
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12
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Huynh W, Vucic S, Krishnan AV, Lin CSY, Kiernan MC. Exploring the Evolution of Cortical Excitability Following Acute Stroke. Neurorehabil Neural Repair 2015; 30:244-57. [PMID: 26150146 DOI: 10.1177/1545968315593804] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Evolution of changes in intracortical excitability following stroke, particularly in the contralesional hemisphere, is being increasingly recognized in relation to maximizing the potential for functional recovery. OBJECTIVE The present study utilized a prospective longitudinal design over a 12-month period from stroke onset, to investigate the evolution of intracortical excitability involving both motor cortices and their relationship to recovery, and whether such changes were influenced by baseline stroke characteristics. METHODS Thirty-one patients with acute unilateral ischemic stroke were recruited from a tertiary hospital stroke unit. Comprehensive clinical assessments and cortical excitability were undertaken at stroke onset using a novel threshold-tracking paired-pulse transcranial magnetic stimulation technique, and repeated at 3-, 6-, and 12-month follow-up in 17 patients who completed the longitudinal assessment. RESULTS Shortly following stroke, short-interval intracortical inhibition (SICI) was significantly reduced in both lesioned and contralesional hemispheres that correlated with degree of recovery over the subsequent 3 months. Over the follow-up period, ipsilesional SICI remained reduced in all patient groups, while SICI over the contralesional hemisphere remained reduced only in the groups with cortical stroke or more baseline functional impairment. CONCLUSIONS The current study has demonstrated that evolution of intracortical excitability, particularly over the contralesional hemisphere, may vary between patients with differing baseline stroke and clinical characteristics, suggesting that ongoing contralesional network recruitment may be necessary for those patients who have significant disruptions to the integrity of ipsilesional motor pathways. Results from the present series have implications for the development of neuromodulatory brain stimulation protocols to harness and thereby facilitate stroke recovery.
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Affiliation(s)
- William Huynh
- Brain and Mind Research Institute, University of Sydney, New South Wales, Australia Prince of Wales Clinical School, University of New South Wales, New South Wales, Australia
| | - Steve Vucic
- Western Clinical School, University of Sydney, New South Wales, Australia
| | - Arun V Krishnan
- Prince of Wales Clinical School, University of New South Wales, New South Wales, Australia
| | - Cindy S-Y Lin
- University of New South Wales, New South Wales, Australia
| | - Matthew C Kiernan
- Brain and Mind Research Institute, University of Sydney, New South Wales, Australia
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13
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Belluzzo M, Mazzon G, Catalan M. Involuntary shoulder jerks after iatrogenic Thoraco-dorsal nerve injury. Parkinsonism Relat Disord 2015; 21:343-4. [PMID: 25603769 DOI: 10.1016/j.parkreldis.2015.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/28/2014] [Accepted: 01/04/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Marco Belluzzo
- University of Trieste, Neurologic Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Trieste, Italy.
| | - Giulia Mazzon
- University of Trieste, Neurologic Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Trieste, Italy
| | - Mauro Catalan
- University of Trieste, Neurologic Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Trieste, Italy
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Propriospinal myoclonus: The spectrum of clinical and neurophysiological phenotypes. Sleep Med Rev 2014; 22:54-63. [PMID: 25500332 DOI: 10.1016/j.smrv.2014.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 10/23/2014] [Accepted: 10/24/2014] [Indexed: 11/23/2022]
Abstract
Propriospinal myoclonus (PSM) is a rare type of spinal myoclonus characterized by muscle jerks that usually start in the midthoracic segments and then slowly propagate up and down into the spinal cord, resulting in repetitive and irregular jerky flexion, or extension of the trunk, neck, knees and hips. PSM can be symptomatic, but up to 80% of reported cases appear idiopathic. PSM tends to occur especially while the subject is lying down. PSM at sleep onset was first described by experts in sleep medicine. The original electrophysiological features included fixed pattern of muscle activations, slow spinal cord conduction (5-15 m/s), electromyographic burst duration less than 1000 ms, synchronous activation of agonist and antagonist muscles and no involvement of facial muscles. PSM has been reported to be a functional (psychogenic) movement disorder in a number of cohorts. The differential diagnosis between idiopathic PSM and the functional forms is not always straightforward. A consistent polymyographically documented muscle activation pattern may be supportive but by no means sufficient and additional neurophysiological investigations are required. PSM should be differentiated from other movement disorders involving the abdomen and trunk, or occurring at sleep-wake transition. This article offers a comprehensive overview of the spectrum of PSM phenotypes.
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15
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Pandey S, Nahab F, Aldred J, Nutt J, Hallett M. Post-traumatic shoulder movement disorders: A challenging differential diagnosis between organic and functional. Mov Disord Clin Pract 2014; 1:102-105. [PMID: 25197686 DOI: 10.1002/mdc3.12016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Peripheral trauma may be a trigger for the development of various movement disorders though the pathophysiology remains controversial and some of these patients have a functional (psychogenic) disorder. We report 3 cases of shoulder movement disorders following trauma to the shoulder region. Physiology was done in all the patients to extend the physical examination. Two patients had history of recurrent shoulder dislocation and were diagnosed with Ehlers-Danlos syndrome. One patient had shoulder injury following repeated falls while performing as a cheerleader. In two patients there were some clinical features suggesting a functional etiology, but physiological studies in all three failed to produce objective evidence of a functional nature. Shoulder movement following trauma is uncommon. Diagnosis in such cases is challenging considering the complex pathophysiology. The movements can be associated with prolonged pain and handicap, and once established they appear resistant to treatment.
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Affiliation(s)
- Sanjay Pandey
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, United States of America, 20892 ; Govind Ballabh Pant Hospital, New Delhi, India 110002
| | | | - Jason Aldred
- Department of Neurology, Gundersen Health System La Crosse, WI 54601-5467
| | - John Nutt
- Oregon Health & Science University Department of Neurology
| | - Mark Hallett
- Govind Ballabh Pant Hospital, New Delhi, India 110002
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16
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Sorokin A, Mittal SO, DiCapua D, Jabbari B. Bilateral gluteal dyskinesia: discussion of a rare movement disorder. Tremor Other Hyperkinet Mov (N Y) 2014; 4:221. [PMID: 24678444 PMCID: PMC3958715 DOI: 10.7916/d8bk19dg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 02/23/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Involuntary movements of gluteal muscles have rarely been reported. CASE REPORT This 46-year-old female with pelvic endometriosis developed involuntary rhythmic movements in the left gluteus maximus, which within a year became bilateral. The movements gradually increased in intensity and interfered with ambulation. Electromyography, at rest, demonstrated almost continuous periodic gluteal discharges, with left-sided discharges seeming to lead to those on the right. OnabotulinumtoxinA injections into the gluteal muscles improved the movements. DISCUSSION A rare and previously unreported form of gluteal involuntary movements with periodic electromyographic discharges is described. The cause is uncertain. The differential diagnosis of this unusual movement disorder is discussed, with the most likely diagnosis being myoclonus.
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Affiliation(s)
- Anna Sorokin
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Shivam Om Mittal
- Department of Neurology, Case Western Reserve University, Cleveland, Ohio, United States of America,*To whom correspondence should be addressed. E-mail:
| | - Daniel DiCapua
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Bahman Jabbari
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America
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17
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Gandhi SE, Kellett MW, Kobylecki C. Botulinum toxin-responsive ear myoclonus following otitis externa. Parkinsonism Relat Disord 2014; 20:265-6. [DOI: 10.1016/j.parkreldis.2013.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/02/2013] [Accepted: 11/17/2013] [Indexed: 11/28/2022]
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Abstract
This chapter reviews focal dyskinesias that affect a restricted region of the body in isolation. Focal dyskinesias often affect body parts not commonly involved in isolation by movement disorders and are not readily classified into one of the major categories of movement disorders or peripheral nerve excitability syndromes. The clinical features and phenomenology of these "unusual focal dyskinesias" are discussed according to the region affected (ear, lip, chin, jaw, tongue, abdomen, and diaphragm (belly dancer's dyskinesias), back, scapula, and limbs). The phenomenology and origin of the unusual focal dyskinesias remain the subject of debate. Most are characterized by slow semirhythmic jerky movements at variable (usually slow) frequencies superimposed on sustained postures, consistent with dystonic movements. However, the body parts affected and pattern of occurrence (in repose rather than during action) are different to those usually seen in primary dystonia. Many of the unusual focal dyskinesias are associated with trauma and pain to the affected region, prompting the suggestion that the movements follow central sensorimotor reorganization occurring spontaneously or secondary to changes in the peripheral nervous system. In other cases, inconsistent signs and spontaneous recovery suggest a psychogenic origin.
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Affiliation(s)
- Annu Aggarwal
- Department of Neurology, Royal Adelaide Hospital and University Department of Medicine, University of Adelaide, Adelaide, Australia
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Carecchio M, Collini A, Comi C, Cantello R, Bhatia KP, Monaco F. Levodopa-induced belly dancer's dyskinesias in Parkinson's disease: report of one case. Mov Disord 2010; 25:1760-2. [PMID: 20645401 DOI: 10.1002/mds.23345] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Schrader C, Capelle H, Kinfe T, Krauss JK. Pallidal deep brain stimulation in belly dancer's dyskinesia. Mov Disord 2009; 24:1698-700. [DOI: 10.1002/mds.22579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abdo WF, Bloem BR, Eijk JJ, Geurts AC, van Alfen N, van de Warrenburg BP. Atypical dystonic shoulder movements following neuralgic amyotrophy. Mov Disord 2009; 24:293-6. [DOI: 10.1002/mds.22398] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Godeiro-Junior C, Felicio AC, Felix EPV, Manzano GM, Silva SMDA, Borges V, Ferraz HB, Barsottini OGP. Moving ear syndrome: The role of botulinum toxin. Mov Disord 2008; 23:122-4. [PMID: 17960817 DOI: 10.1002/mds.21773] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Clecio Godeiro-Junior
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil.
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Shamim EA, Hallett M. Intramedullary spinal tumor causing “belly dancer syndrome”. Mov Disord 2007; 22:1673-4. [PMID: 17216647 DOI: 10.1002/mds.21280] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Alonso-Navarro H, Puertas I, Cabrera-Valdivia F, de Toledo-Heras M, García-Albea E, Jiménez-Jiménez FJ. Posterior auricular muscle ?dystonia? Eur J Neurol 2007; 14:e14-5. [PMID: 17594306 DOI: 10.1111/j.1468-1331.2007.01821.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schwingenschuh P, Wenzel K, Katschnig P, Saurugg R, Ott E. Case of a palatal tic resembling palatal tremor in a patient with Tourette syndrome. Mov Disord 2007; 22:742-5. [PMID: 17266076 DOI: 10.1002/mds.21395] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We describe a case of a palatal tic resembling palatal tremor (PT) in a young female patient with a previously unrecognized mild Tourette syndrome. At the time of her visit, the patient complained about ear clicks that were audible to others. We discuss the differential diagnoses of hyperkinetic palatal movements emphasizing the ongoing discussion about essential PT representing a more heterogeneous disorder than previously thought.
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Roggendorf J, Burghaus L, Liu WC, Weisenbach S, Eggers C, Fink GR, Hilker R. Belly dancer's syndrome following central pontine and extrapontine myelinolysis. Mov Disord 2007; 22:892-4. [PMID: 17290456 DOI: 10.1002/mds.21394] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We report on a woman with delayed-onset of belly dancer's syndrome 5 months after central pontine and extrapontine myelinolysis (CPM/EPM) and severe hyponatriemia. This case demonstrates that basal ganglia lesions in EPM can be the underlying pathoanatomic substrate for the rarely observed belly dancer's syndrome. The sequential appearance of extrapyramidal symptoms might reflect an ongoing but ineffective or deficient remyelination process. The presence of CPM/EPM should be considered in patients with involuntary dyskinesias of the abdominal wall.
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Linazasoro G, Van Blercom N, Lasa A, Fernández JM, Aranzábal I. Etiological and therapeutical observations in a case of belly dancer's dyskinesia. Mov Disord 2004; 20:251-3. [PMID: 15455446 DOI: 10.1002/mds.20312] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report on the case of a woman with belly dancer's syndrome. This case presented two peculiarities: (1) the condition was induced by the chronic use of clebopride, and (2) abdominal dyskinesias showed a dramatic response to the application of transcutaneous electrical nerve stimulation.
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Affiliation(s)
- Girutz Linazasoro
- Centro de Neurología y Neurocirugía funcional, Clínica Quirón Donostia, San Sebastián, Gipuzokoa, Spain.
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Dziewas R, Kuhlenbäumer G, Okegwo A, Lüdemann P. Painless legs and moving toes in a mother and her daughter. Mov Disord 2003; 18:718-22. [PMID: 12784282 DOI: 10.1002/mds.10435] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Painful legs and moving toes (PLMT) is a rare syndrome which is characterised by involuntary movements of the toes and pain in the legs. We report on a mother and her daughter who both presented with involuntary movements of the toes similar to those seen in PLMT but without any associated pain. Neurological examination revealed intermittent 0.3 to 0.5-Hz flexion and extension of the toes and ankles of the right foot in the mother, and of both feet in the daughter. In both patients, the movements appeared during periods of rest that were uncorrelated with the time of day. Diagnostic work-up gave no evidence of radiculopathy or of focal neuropathy. Overnight polysomnography documented that movements of the toes and feet occurred only before sleep onset and during periods of nocturnal awakening or arousals. Because the movements observed in our patients were similar to those seen in patients with PLMT, we diagnosed an abortive form of this syndrome, which already has got the naming "painless legs and moving toes." The occurrence in a mother and her daughter may point to a hereditary component of this disorder.
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Affiliation(s)
- Rainer Dziewas
- Department of Neurology, University Hospital Münster, Münster, Germany.
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Affiliation(s)
- M S Lee
- Department of Neurology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Affiliation(s)
- G M Wali
- Department of Neurology, Jawaharlal Nehru Medical College, Belgaum, India
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Affiliation(s)
- F Cardoso
- Movement Disorders Clinic, Department of Neurology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Affiliation(s)
- G M Wali
- Department of Neurology, Jawaharlal Nehru Medical College, KLE Society's Hospital & Medical Research Centre, Belgaum, India
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Abstract
Craniofacial dyskinesias encompass a variety of abnormal spontaneous craniofacial movements that often appear similar in morphology but are, in fact, of varied cause and nature. Although hemifacial spasm and blepharospasm are the two most common abnormal craniofacial movements, the clinician should be cognizant of other dyskinesias, particularly craniofacial dystonias, tremor, tic, chorea, and stereotypies. Most craniofacial dyskinesias respond favorably to injections of botulinum toxin type A or oral medications. Surgical treatment may be beneficial for refractory cases.
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Affiliation(s)
- V G Evidente
- Department of Neurology, Mayo Clinic Scottsdale, Arizona 85259, USA
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Straube A, Mai N, Walther E, Mayer M. Persisting "writer's cramp" as a result of compensation of a temporary palsy due to a hereditary neuropathy with liability to pressure palsies. Mov Disord 1996; 11:576-9. [PMID: 8866501 DOI: 10.1002/mds.870110515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A 49-year-old man reported several periods of acute paresis of different nerves after exposure to pressure. All palsies showed a good recovery over a period of days to months. The suspected diagnosis of a hereditary neuropathy with liability to pressure palsies was confirmed by the histology of a suralis nerve biopsy, which showed a distinct tomaculous swelling of the myelin. Nine years ago he noticed an acute, distally pronounced palsy of the right arm. A brachial plexus lesion was diagnosed. His profession required written work, thereby forcing him to compensate this weakness by increasing the coactivation of the elbow and upper arm. This coactivation persisted even after complete recovery from the plexus palsy. Thus, the patient showed the typical feature of classical writer's cramp, with broad coactivation of the arm muscles, which has continued to the present. At the same time, however, the patient was able to perform other motoric tasks well, such as painting. After several practice sessions with a special program that makes use of preserved motor abilities to reestablish writing, the patient was again able to write with a normal kinematic profile as documented by the recorded handwriting. This suggests that the "writer's cramp" of our patient is one form of task-related dystonia that may be related more to the perserveration of a misleading motor strategy than to a general inability of the motor system to control the movement properly.
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Affiliation(s)
- A Straube
- Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany
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Shan DE, Kwan SY, Ho HH, Su MS. Belly dystonia induced by levodopa and biperiden in a case of suspected multiple-system atrophy. Mov Disord 1996; 11:455-7. [PMID: 8813234 DOI: 10.1002/mds.870110423] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- D E Shan
- Veterans General Hospital, Department of Neurology, School of Medicine,National Yang-Ming University, Taipei, Taiwan, Republic of China
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