Delayed radiation-induced bulbar palsy mimicking ALS.
We describe a patient presenting with progressive bulbar dysfunction and spasticity that clinically mimicked amyotrophic lateral sclerosis (ALS). Electromyography, however, showed no evidence of denervation and revealed a rare combination of peripheral and central myokymia. We feel that this pattern of myokymia represented a marker of neural injury from remote radiation therapy. Nervous system disorders resulting from therapeutic radiation are described, and potential pathophysiologic mechanisms underlying myokymia are discussed.
Glenn
S A
SA
Cedar Neurology, 4201 Lake Boone Trail, Suite 100, Raleigh, North Carolina 27607, USA. cgandsw@earthlink.net
Ross
M A
MA
D010244:Bulbar Palsy, Progressive / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*