Toe pseudoathetosis in vitamin B12 deficiency

Sciacca, Giorgia; Pira, Francesco Le; Mostile, Giovanni; Zappia, Mario

doi:10.1111/ene.12972

Cited by 2 publications

(3 citation statements)

References 7 publications

(7 reference statements)

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“…Since phenomenologically, it is identical to athetosis of central origin, a more appropriate term should be "proprioceptive athetosis." Typically involving the fingers or toes, in contrast to central athetosis, the proprioceptive athetosis (pseudoathetosis) usually worsens when the eyes are closed [121]. There are many etiologies of pseudoathetosis, but it is typically caused by large fiber peripheral neuropathy [121][122][123].…”

Section: Miscellaneous Peripherally-induced Movement Disordersmentioning

confidence: 99%

“…Typically involving the fingers or toes, in contrast to central athetosis, the proprioceptive athetosis (pseudoathetosis) usually worsens when the eyes are closed [121]. There are many etiologies of pseudoathetosis, but it is typically caused by large fiber peripheral neuropathy [121][122][123]. Proprioception abnormalities secondary to CNS lesions, such as parietal cortex stroke [124], neuromyelitis optica [125], or cervical myelopathy [126] may also cause pseudoathetosis.…”

Section: Miscellaneous Peripherally-induced Movement Disordersmentioning

confidence: 99%

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Peripherally-induced Movement Disorders: An Update

Lenka¹,

Jankovic

2023

Tremor and Other Hyperkinetic Movements

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Background: Peripherally-induced movement disorders (PIMD) should be considered when involuntary or abnormal movements emerge shortly after an injury to a body part. A close topographic and temporal association between peripheral injury and onset of the movement disorders is crucial to diagnosing PIMD. PIMD is under-recognized and often misdiagnosed as functional movement disorder, although both may co-exist. Given the considerable diagnostic, therapeutic, and psychosocial-legal challenges associated with PIMD, it is crucial to update the clinical and scientific information about this important movement disorder.Methods: A comprehensive PubMed search through a broad range of keywords and combinations was performed in February 2023 to identify relevant articles for this narrative review. Results:The spectrum of the phenomenology of PIMD is broad and it encompasses both hyperkinetic and hypokinetic movements. Hemifacial spasm is probably the most common PIMD. Others include dystonia, tremor, parkinsonism, myoclonus, painful leg moving toe syndrome, tics, polyminimyoclonus, and amputation stump dyskinesia. We also highlight conditions such as neuropathic tremor, pseudoathetosis, and MYBPC1associated myogenic tremor as examples of PIMD.Discussion: There is considerable heterogeneity among PIMD in terms of severity and nature of injury, natural course, association with pain, and response to treatment. As some patients may have co-existing functional movement disorder, neurologists should be able to differentiate the two disorders. While the exact pathophysiology remains elusive, aberrant central sensitization after peripheral stimuli and maladaptive plasticity in the sensorimotor cortex, on a background of genetic (two-hit hypothesis) or other predisposition, seem to play a role in the pathogenesis of PIMD.

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Section: Miscellaneous Peripherally-induced Movement Disordersmentioning

confidence: 99%

Section: Miscellaneous Peripherally-induced Movement Disordersmentioning

confidence: 99%

Peripherally-induced Movement Disorders: An Update

Lenka¹,

Jankovic

2023

Tremor and Other Hyperkinetic Movements

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“…Pseudodystonia is also common in subacute combined degeneration (Video 2), where it can result from a combination of peripheral nerve and posterior column damage and improves with B12 supplementation [24,25]. Pseudodystonic postures due to proprioceptive loss may be characteristic of Miller-Fisher syndrome (Fig.…”

Section: Disorders Of the Sensory Pathwaysmentioning

confidence: 99%

Pseudodystonia: A new perspective on an old phenomenon

Berlot

Bhatia

Kojović

2019

Parkinsonism & Related Disorders

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Pseudodystonia represents a wide range of conditions that mimic dystonia, including disorders of the peripheral nervous system, spinal cord, brainstem, thalamus, cortex and non-neurological conditions such as musculoskeletal diseases. Here, we propose a definition of pseudodystonia and suggest a classification based on underlying pathophysiological mechanisms. We describe phenomenology of different forms of pseudodystonia and point to distinctions between dystonia and pseudodystonia as well as challenging issues that may arise in clinical practice. The term pseudodystonia can be used to describe abnormal postures, repetitive movements or both, in which results of clinical, imaging, laboratory or electrophysiological investigations provide definite explanation of symptoms which is not compatible with dystonia. Pseudodystonia can be classified into non-neurological disorders of the musculoskeletal system, disorders of sensory pathways, disorders of motor pathways and compensatory postures in other neurological diseases. Presence of associated neurological findings in the affected body part is the key towards diagnosis of pseudodystonia. Additional supporting features are the presence of fixed postures, the absence of sensory trick, acute mode of onset and severe pain. Worsening on eye closure, traditionally considered typical for pseudodystonia, is not always present and can also appear in dystonia. It is challenging to separate dystonia and pseudodystonia in patients with thalamic lesions or corticobasal syndrome, where abnormal postures coexist with sensory loss. Many cases of pseudodystonia are treatable. Therefore, it is essential to consider pseudodystonia in a differential diagnosis of abnormal postures until a detailed neurological examination rules it out.

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Toe pseudoathetosis in vitamin B12 deficiency

Cited by 2 publications

References 7 publications

Peripherally-induced Movement Disorders: An Update

Peripherally-induced Movement Disorders: An Update

Pseudodystonia: A new perspective on an old phenomenon

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