Brainstem myoclonus in a patient with non-dopa-responsive parkinsonism

被引:28
作者
Clouston, PD
Lim, CL
Fung, V
Yiannikas, C
Morris, JGL
机构
[1] WESTMEAD HOSP,DEPT NEUROL,MOTOR CONTROL & MOVEMENT DISORDER LAB,WESTMEAD,NSW 2145,AUSTRALIA
[2] UNIV SYDNEY,DEPT MED NEUROL,SYDNEY,NSW 2006,AUSTRALIA
关键词
parkinsonism; myoclonus; stimulus-sensitive myoclonus; brainstem myoclonus; reticular reflex myoclonus; startle response;
D O I
10.1002/mds.870110409
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
In the few reports where electrophysiologic techniques have been used to characterise stimulus-sensitive myoclonus in the setting of a parkinsonian syndrome, the origin of the myoclonus has usually been found to be cortical. We describe a patient with parkinsonism unresponsive to levodopa who had myoclonus that was both spontaneous and induced by somatosensory stimuli. In addition, autonomic symptoms and a marked sleep disturbance were present early in his illness, Results of electrophysiologic investigations including electromyography (EMG) studies, routine electroencephalography (EEG) recording, jerked locked back-averaging of EEG, and somatosensory evoked potentials were consistent with a brainstem origin for the myoclonic jerks. Following ipsilateral digital and supraorbital electrical stimulation, the earliest muscle activation occurred in the trapezius. An all-night sleep study showed frequent myoclonic jerks during sleep and markedly abnormal sleep architecture. We believe that this patient's myoclonus was related to pathologic changes in brainstem reticular nuclei that occurred as part of his disease process. To our knowledge, brainstem myoclonus has not been described as a feature of parkinsonian syndromes.
引用
收藏
页码:404 / 410
页数:7
相关论文
共 20 条
  • [1] ALDRICH MS, 1989, PRINCIPLES PRACTICE, P351
  • [2] THE PATHOPHYSIOLOGY AND PHARMACOLOGY OF PHOTIC CORTICAL REFLEX MYOCLONUS
    ARTIEDA, J
    OBESO, JA
    [J]. ANNALS OF NEUROLOGY, 1993, 34 (02) : 175 - 184
  • [3] BERARDELLI A, 1991, EXP BRAIN RES, V87, P402
  • [4] MYOCLONUS IN PAPIO-PAPIO
    BRAILOWSKY, S
    [J]. MOVEMENT DISORDERS, 1991, 6 (02) : 98 - 104
  • [5] THE HYPEREKPLEXIAS AND THEIR RELATIONSHIP TO THE NORMAL STARTLE REFLEX
    BROWN, P
    ROTHWELL, JC
    THOMPSON, PD
    BRITTON, TC
    DAY, BL
    MARSDEN, CD
    [J]. BRAIN, 1991, 114 : 1903 - 1928
  • [6] NEW OBSERVATIONS ON THE NORMAL AUDITORY STARTLE REFLEX IN MAN
    BROWN, P
    ROTHWELL, JC
    THOMPSON, PD
    BRITTON, TC
    DAY, BL
    MARSDEN, CD
    [J]. BRAIN, 1991, 114 : 1891 - 1902
  • [7] BROWN P, 1990, Neurology, V40, P386
  • [8] A CASE OF POSTANOXIC ENCEPHALOPATHY WITH CORTICAL ACTION AND BRAIN-STEM RETICULAR REFLEX MYOCLONUS
    BROWN, P
    THOMPSON, PD
    ROTHWELL, JC
    DAY, BL
    MARSDEN, CD
    [J]. MOVEMENT DISORDERS, 1991, 6 (02) : 139 - 144
  • [9] STIMULUS-SENSITIVE MYOCLONUS IN AKINETIC-RIGID SYNDROMES
    CHEN, R
    ASHBY, P
    LANG, AE
    [J]. BRAIN, 1992, 115 : 1875 - 1888
  • [10] ANTEMORTEM DIAGNOSIS OF DIFFUSE LEWY BODY DISEASE
    CRYSTAL, HA
    DICKSON, DW
    LIZARDI, JE
    DAVIES, P
    WOLFSON, LI
    [J]. NEUROLOGY, 1990, 40 (10) : 1523 - 1528