Benign segmental myoclonus: electrophysiological evidence of transient dysfunction in the brainstem.
We present a 66-year-old patient with segmental myoclonus evoked by a brainstem infarction. The myoclonus appeared soon after a cerebrovascular accident and it was evident in the soft palate, jaw, neck, shoulders and upper limbs. Brain MRI showed infarction in the left pons and left cerebellum. Small amounts of orally administered clonazepam were remarkably effective. Electroencephalogram (EEG) and auditory brainstem response (ABR) were normal. Somatosensory evoked potential (SSEP) revealed delays in P 14 and N19 recorded at C3 by right median nerve stimulation. These findings were normalized in 4 days. Seg-mental myoclonus is thought to be evoked by olivary hypertrophy following cerebrovascular accident in the brainstem and is said to be resistant to medication. The limited involvement of the brainstem in our patient may account for the transient segmental myoclonus. The prognosis for this type of segmental myoclonus is excellent.
Yoshikawa
H
H
Department of Neurology, Kanazawa University School of Medicine, Kanazawa, Japan. hiroaki@kenroku.kanazawa-u.ac.jp
Takamori
M
M
D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage; D020526:Brain Stem Infarctions / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D002531:Cerebellum / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002998:Clonazepam / Q000008:administration & dosage; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D009207:Myoclonus / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D011149:Pons / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
D000927:Anticonvulsants; D002998:Clonazepam