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van der Salm SMA, Erro R, Cordivari C, Edwards MJ, Koelman JHTM, van den Ende T, Bhatia KP, van Rootselaar AF, Brown P, Tijssen MAJ. Propriospinal myoclonus: clinical reappraisal and review of literature. Neurology 2014; 83:1862-70. [PMID: 25305154 DOI: 10.1212/wnl.0000000000000982] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Propriospinal myoclonus (PSM) is a rare disorder with repetitive, usually flexor arrhythmic brief jerks of the trunk, hips, and knees in a fixed pattern. It has a presumed generation in the spinal cord and diagnosis depends on characteristic features at polymyography. Recently, a historical paradigm shift took place as PSM has been reported to be a functional (or psychogenic) movement disorder (FMD) in most patients. This review aims to characterize the clinical features, etiology, electrophysiologic features, and treatment outcomes of PSM. METHODS Re-evaluation of all published PSM cases and systematic scoring of clinical and electrophysiologic characteristics in all published cases since 1991. RESULTS Of the 179 identified patients with PSM (55% male), the mean age at onset was 43 years (range 6-88 years). FMD was diagnosed in 104 (58%) cases. In 12 cases (26% of reported secondary cases, 7% of total cases), a structural spinal cord lesion was found. Clonazepam and botulinum toxin may be effective in reducing jerks. CONCLUSIONS FMD is more frequent than previously assumed. Structural lesions reported to underlie PSM are scarce. Based on our clinical experience and the reviewed literature, we recommend polymyography to assess recruitment variability combined with a Bereitschaftspotential recording in all cases.
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Affiliation(s)
- Sandra M A van der Salm
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Roberto Erro
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Carla Cordivari
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Mark J Edwards
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Johannes H T M Koelman
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Tom van den Ende
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Kailash P Bhatia
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Anne-Fleur van Rootselaar
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Peter Brown
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Marina A J Tijssen
- From the Department of Neurology and Clinical Neurophysiology (S.M.A.v.d.S., J.H.T.M.K., T.v.d.E., A.-F.v.R.), Academic Medical Center, Amsterdam, the Netherlands; Sobell Department of Motor Neuroscience and Movement Disorders (R.E., C.C., M.J.E., K.P.B.), University College London (UCL) Institute of Neurology, London; Clinical Neurophysiology (R.E., C.C.), National Hospital for Neurology and Neurosurgery, London; Nuffield Department of Clinical Neurosciences (P.B.), University of Oxford, John Radcliffe Hospital, Oxford, UK; and the Department of Neurology (M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands.
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Roze E, Apartis E, Vidailhet M, Cochen V, Beaugendre Y, Trocello JM, Lasjaunias P, Ducreux D. Propriospinal myoclonus: Utility of magnetic resonance diffusion tensor imaging and fiber tracking. Mov Disord 2007; 22:1506-1509. [PMID: 17523193 DOI: 10.1002/mds.21562] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Propriospinal myoclonus (PSM) is a rare movement disorder characterized by involuntary spinal-generated muscular jerks that spread rostrally and caudally to other spinally innervated muscles. Most patients have no clear etiology, and conventional MRI of the spinal cord is generally normal. Here we report the use of magnetic resonance diffusion tensor imaging (DTI) and fiber tracking to detect tract-specific abnormalities in a patient with propriospinal myoclonus. As the patient had the fragile-X premutation and antithyroid antibodies, spinal cord DTI abnormalities may be related to these conditions. Tract-specific analysis may provide new insights into the pathophysiology of propriospinal myoclonus.
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Affiliation(s)
- Emmanuel Roze
- Department of Neurology, Saint-Antoine Hospital, AP-HP, Paris, France
- CNRS UMR 7102, Paris VI University, Paris, France
| | - Emmanuelle Apartis
- Department of Neurophysiology, Saint Antoine Hospital, AP-HP, Paris, France
- INSERM U732, Paris VI University, Paris, France
| | - Marie Vidailhet
- Department of Neurology, Saint-Antoine Hospital, AP-HP, Paris, France
- INSERM U679, Paris, France
| | - Valérie Cochen
- Department of Neurology, Saint-Antoine Hospital, AP-HP, Paris, France
- INSERM U679, Paris, France
| | - Yara Beaugendre
- Department of Neurophysiology, Saint Antoine Hospital, AP-HP, Paris, France
- Department of Neurophysiology, Henri Mondor Hospital, AP-HP, Creteil, France
| | - Jean-Marc Trocello
- Department of Neurology, Saint-Antoine Hospital, AP-HP, Paris, France
- Department of Neurophysiology, Saint Antoine Hospital, AP-HP, Paris, France
- INSERM U732, Paris VI University, Paris, France
| | - Pierre Lasjaunias
- Department of Neuroradiology, Bicêtre Hospital, AP-HP, Paris, France
| | - Denis Ducreux
- Department of Neuroradiology, Bicêtre Hospital, AP-HP, Paris, France
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