title: Convulsive-like movements in brainstem stroke.
abstract: BACKGROUND
  Involuntary convulsive-like movements sometimes occur in patients with brainstem strokes. These movements vary in nature, frequency, and trigger, including fasciculation-like, shivering, jerky, tonic-clonic, and intermittent shaking movements. Some are interpreted as decerebrate postures or seizures. It is important to recognize this type of motor phenomenon since it may be a diagnostic clue for early diagnosis and treatment of brainstem strokes.
  
  
  METHODS
  Case report and review of the literature
  
  
  METHODS
  A 72-year-old-man presented with impaired consciousness and jerks of the upper limbs mimicking seizures. These episodes consisted of brief clonic contractions of the proximal and distal upper extremities. They were observed in paroxysms lasting for 3 to 5 seconds. Magnetic resonance imaging showed large midpontine infarction. Magnetic resonance angiography revealed the absence of basilar artery blood flow. No seizure discharges were observed in the electroencephalogram. Anticoagulation with intravenous heparin was started. Two days after admission, the patient had a cardiac arrest and died. We review the frequency and nature of convulsive-like movements in brainstem stroke in the literature.
  
  
  CONCLUSIONS
  Movements associated with brainstem lesions are not easily differentiated from convulsions. Unexpected onset and inexperience of the observers limit the characterization of this phenomenon. Convulsive-like movements in brainstem stroke may occur more frequently than reported. Early detection of this motor phenomenon may have practical implications.
authors: gsaposnik@intramed.net.ar
authors: G
authors: G
authors: Saposnik
authors: L R
authors: LR
authors: Caplan
mesh_terms: D000368:Aged; D001933:Brain Stem / Q000098:blood supply* / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000209:etiology* / Q000503:physiopathology*; D012640:Seizures / Q000503:physiopathology*; D020521:Stroke / Q000150:complications* / Q000175:diagnosis