title: Unique form of propriospinal myoclonus as a possible complication of an enteropathogenic toxin.
abstract: Propriospinal myoclonus is an uncommon form of spinal myoclonus propagated, presumably, by slowly conducting polysynaptic intraspinal pathways. Although most patients demonstrate no clear etiology, a variety of disorders have been linked to this abnormal movement, including trauma, multiple sclerosis, tumors, and infectious disorders such as herpes zoster, human immunodeficiency virus, and Lyme disease. We describe 2 young male patients from the same town in Northern Ontario, Canada, exposed to an outbreak of Escherichia coli O157:H7 from contaminated municipal water, who developed identical clinical and electrophysiological features suggestive of a rhythmic form of propriospinal myoclonus with activity alternating between abdominal and paraspinal muscles. A toxin-mediated microvascular thrombosis is proposed as a possible pathogenic mechanism underlying this novel association.
authors.affiliation: Department of Medicine, Division of Neurology, The Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Espay
authors.forename: Peter
authors.initials: P
authors.lastname: Ashby
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Hanajima
authors.forename: Mandar S
authors.initials: MS
authors.lastname: Jog
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004576:Electromyography / Q000295:instrumentation; D004768:Enterotoxins; D004781:Environmental Exposure / Q000009:adverse effects; D004927:Escherichia coli Infections / Q000150:complications*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000382:microbiology* / Q000503:physiopathology*; D009207:Myoclonus / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D013131:Spine; D014743:Videotape Recording
chemical_list: D004768:Enterotoxins