[Myorhythmia emerging on day 15 in a case of an infarction in the midbrain-pontine tegmentum].
A 72-year-old woman was admitted to our hospital because of dysarthria, dysstasia, and diplopia. Examination demonstrated wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome, dysarthria, truncal ataxia, and dysmetria of the four limbs. Cranial MR images demonstrated an acute infarct in the paramedian, lower midbrain-pontine tegmentum. Peduncular hallucinosis was observed during the first several days of hospitalization. Myorhythmia (skeletal myoclonus) appeared as early as day 15 and has persisted to date, with a frequency of approximately 1.5 Hz on the head and chin, and 3.5 Hz on the left upper extremity. Cranial MR images 5 months after onset demonstrated bilateral inferior olivary hypertrophy, while palatal tremor appeared later. Only a limited number of case reports are available in which myorhythmia emerged as early as in our case after the onset of a brain infarct.
Shinohara
Miho
M
Department of Neurology, Osaka Saiseikai Nakatsu Hospital.
Tatsumi
Shinsui
S
Yamamoto
Toru
T
D000368:Aged; D020526:Brain Stem Infarctions / Q000150:complications*; D005260:Female; D006212:Hallucinations / Q000209:etiology; D006801:Humans; D006984:Hypertrophy / Q000209:etiology; D008636:Mesencephalon / Q000098:blood supply*; D009847:Olivary Nucleus / Q000473:pathology; D009886:Ophthalmoplegia / Q000209:etiology; D011149:Pons / Q000098:blood supply*; D013681:Tegmentum Mesencephali / Q000098:blood supply*; D014202:Tremor / Q000209:etiology*