Botulinum toxin treatment of facial myoclonus in suspected Rasmussen encephalitis.
Patients with Rasmussen encephalitis (RE) may develop a variety of involuntary movements. We report a 26-year-old woman who presented with a 3-year history of progressive, continuous myoclonus of the left side of the face and left arm as well as left spastic hemiparesis. Magnetic resonance imaging of the brain showed right hemisphere and basal ganglia atrophy, and 24-hour electroencephalogram demonstrated diffuse slowing with random sharp waves in both hemispheres. An 18-fluoro-deoxy-glucose positron emission tomography scan indicated hypometabolism of the right cerebral hemisphere, including basal ganglia and thalamus. We successfully treated her myoclonus with injections of botulinum toxin A into the left zygomaticus muscle.
Browner
Nina
N
Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Azher
Shaheda N
SN
Jankovic
Joseph
J
D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage; D001284:Atrophy; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002421:Caudate Nucleus / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D004292:Dominance, Cerebral / Q000502:physiology; D004351:Drug Resistance; D004660:Encephalitis / Q000188:drug therapy*; D017036:Epilepsia Partialis Continua / Q000188:drug therapy*; D004831:Epilepsies, Myoclonic / Q000188:drug therapy*; D005152:Facial Muscles / Q000187:drug effects*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D016896:Treatment Outcome
D000927:Anticonvulsants; D019274:Botulinum Toxins, Type A