A posttraumatic thalamic lesion associated with contralateral action myoclonus

Jacob, P. C.; Chand, R. Pratap

doi:10.1002/1531-8257(199905)14:3<512::aid-mds1022>3.0.co;2-7

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…Action and stimulus‐sensitive myoclonus are a common feature of this entity, which may start with a focal involvement in absence of additional typical symptoms, such as seizures, progressive cerebellar ataxia, or malabsorption syndrome . Head injury and focal brain lesions can also trigger focal action myoclonus, but they are usually associated with focal neurological deficits. Focal myoclonus can be a feature of corticobasal syndrome .…”

Section: Discussionmentioning

confidence: 99%

Focal Predominant Forms of Posthypoxic Action Myoclonus

Gasca‐Salas

Lang

2016

Movement Disord Clin Pract

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Chronic posthypoxic action myoclonus is usually recognized as multifocal or generalized and, in most cases, causes severe disability. It is also commonly associated with other neurological symptoms, such as ataxia. We report two cases of focal predominant postanoxic action myoclonus and review the limited relevant literature. The first case presented with action and stimulus sensitive myoclonus in the lower limbs that caused him limited disability. He had not received any diagnosis in almost 2 years. The second patient exhibited predominantly focal facial myoclonus, although she was more limited by dysphasia and hemiplegia as a consequence of an ischemic stroke. Both patients responded to antiepileptic drugs. We found 9 of 159 previously reported cases with this focal distribution. Physicians should be aware of this limited phenotype given that the unusual focal nature of the movements may result in incorrect diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Focal Predominant Forms of Posthypoxic Action Myoclonus

Gasca‐Salas

Lang

2016

Movement Disord Clin Pract

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Disorders of Movement due to Acquired and Traumatic Brain Injury

Moon

2022

Curr Phys Med Rehabil Rep

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Purpose of Review Both traumatic and acquired brain injury can result in diffuse multifocal injury affecting both the pyramidal and extrapyramidal tracts. Thus, these patients may exhibit signs of both upper motor neuron syndrome and movement disorder simultaneously which can further complicate diagnosis and management. We will be discussing movement disorders following acquired and traumatic brain injury. Recent Findings Multiple functions including speech, swallowing, posture, mobility, and activities of daily living can all be affected. Medical treatment and rehabilitation-based therapy can be especially challenging due to accompanying cognitive deficits and severity of the disorder which can involve multiple limbs in addition to muscles of the face and axial skeleton. Tremor and dystonia are the most reported movement disorders following traumatic brain injury. Dystonia and myoclonus are well documented following hypoxic ischemic brain injuries. Electrophysiological studies such as dynamic surface poly-electromyography can assist with identifying phenomenology, especially differentiating between jerk-like phenomenon and help guide further work up and management. Management with medications remains challenging due to potential adverse effects. Surgical interventions including stereotactic surgery, deep brain stimulation, and intrathecal baclofen pumps have been reported, but most of the evidence supporting them has been limited to primarily case reports except for post-traumatic tremor. Summary Brain injury can lead to motor disorders, movement disorders, visual (processing) deficits, and vestibular deficits which often coexist with cognitive deficits making it challenging to treat and rehabilitate these patients. Unfortunately, the evidence regarding the medical management and rehabilitation of brain injury patients with movement disorders is sparse and leaves much to be desired.

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Myoclonus in the critically ill: Diagnosis, management, and clinical impact

Sutter

Ristic

Rüegg

et al. 2016

Clinical Neurophysiology

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Myoclonus is the second most common involuntary non-epileptic movement in intensive care units following tremor-like gestures. Although there are several types of myoclonus, they remain underappreciated, and their diagnostic and prognostic associations are largely ignored. This review discusses clinical, electrophysiological, neuroanatomical, and neuroimaging characteristics of different types of myoclonus in critically ill adults along with their prognostic impact and treatment options. Myoclonus is characterized by a sudden, brief, and sometimes repetitive muscle contraction of body parts, or a brief and sudden cessation of tonic muscle innervation followed by a rapid recovery of tonus. Myoclonus can resemble physiologic and other pathologic involuntary movements. Neurologic injuries, anesthetics, and muscle relaxants interfere with the typical appearance of myoclonus. Identifying "real myoclonus" and determining the neuroanatomical origin are important, as treatment responses depend on the involved neuroanatomical structures. The identification of the type of myoclonus, the involved neuroanatomical structures, and the associated illnesses is essential to direct treatment. In conclusion, the combined clinical, electrophysiological, and neuroradiological examination reliably uncovers the neuroanatomical sources and the pathophysiology of myoclonus. Recognizing cortical myoclonus is critical, as it is treatable and may progress to generalized convulsive seizures or status epilepticus.

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A posttraumatic thalamic lesion associated with contralateral action myoclonus

Cited by 5 publications

References 8 publications

Focal Predominant Forms of Posthypoxic Action Myoclonus

Focal Predominant Forms of Posthypoxic Action Myoclonus

Disorders of Movement due to Acquired and Traumatic Brain Injury

Myoclonus in the critically ill: Diagnosis, management, and clinical impact

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