Hiccup-like segmental myoclonus in thoracic compressive myelopathy: a case report

Abstract

Study design: A case report. Objectives: This study discusses a case of spinal segmental myoclonus caused by thoracic myelopathy, mimicking hiccup spasms. Spinal myoclonus caused by thoracic myelopathy is extremely rare. It can be misdiagnosed as chronic intractable hiccups due to similar clinical manifestations. Setting: Korea University Anam Hospital, Seoul, Republic of Korea. Methods: A 42-year-old man presented with a history of involuntary jerky movement of the upper abdominal wall muscles that had been continuing for over 3 years. A neurological examination, brain computed tomography and electroencephalogram did not reveal a cause of the symptoms. Electromyography was performed on the abdominal muscles and the findings revealed were compatible with spinal myoclonus. The spinal myoclonus had started in the abdominal muscles, with a spinal magnetic resonance imaging revealing a disc protrusion compressing the anterior spinal cord. Results: The cause of the spinal myoclonus was determined to be spinal myelopathy due to mild T7 disc protrusion. The patient refused surgical or invasive interventions and was conservatively treated with clonazepam. The symptoms were reported to be less frequent following the treatment. Conclusion: Compressive myelopathy developed from disc protrusion may cause spinal myoclonus mimicking as hiccup spasms.

A case of spinal myoclonus in a patient with elective cesarean section

“…In this patient, midazolam was administrated during surgery. Some reports have suggested that the antiepileptic drug benzodiazepines may be useful in treating patients with SM-NA [10,11]; however, a preceding administration of midazolam may contribute to few prophylactic effects for SM-NA. SM-NA sometimes presents in a severe form, which can cause unexpected perioperative complications.…”

Involuntary anterior abdominal wall movements: A rare presentation of truncal epilepsia partialis continua due to stroke

“…Involuntary truncal movements are usually seen in clinical practice as part of generalized movement disorder but are rare in isolation. Belly dancer's dyskinesias 1 , truncal dystonia 2 , propriospinal myoclonus 3 , focal motor seizures 4 , and intractable hiccups 5 share a common phenotype of abdominal wall movements. The aetiological spectrum of the abnormal involuntary movements of the anterior abdominal wall is quite variable.…”