title: Involuntary craniofacial lingual movements in intensive care-acquired quadriplegia.
abstract: BACKGROUND
  The syndrome of involuntary craniofacial lingual movements in the setting of acute intensive care-acquired quadriplegia (critical illness neuromyopathy) following sepsis-associated encephalopathy has not been previously described. We suggest a localization and treatment for this disabling condition.
  
  
  METHODS
  Three patients (2 female) from our center were quadriplegic from critical illness neuromyopathy when they developed involuntary craniofacial lingual movements following sepsis-associated encephalopathy.
  
  
  RESULTS
  Extensive investigations failed to identify an etiology for the abnormal movements. Movements were of large amplitude, of moderate speed, and semi-rhythmic in the jaw, tongue, and palate, persistent and extremely bothersome to all patients. Injection with Botulinum toxin type A was very beneficial.
  
  
  CONCLUSIONS
  Involuntary craniofacial lingual movements in the setting of flaccid quadriplegia following sepsis-associated encephalopathy are consistent with focal craniofacial brainstem myoclonus and constitutes a new syndrome. Botulinum toxin type A treatment maybe helpful in treatment.
authors: Department of Clinical Neurological Sciences, Schulich School of Medicine, The University of Western Ontario, London, ON, Canada. acartage@uwo.ca
authors: A M
authors: AM
authors: Cartagena
authors: M
authors: M
authors: Jog
authors: G B
authors: GB
authors: Young
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D016638:Critical Illness; D020820:Dyskinesias / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D004660:Encephalitis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D011782:Quadriplegia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D018805:Sepsis / Q000150:complications / Q000188:drug therapy; D013577:Syndrome; D014059:Tongue / Q000503:physiopathology*
chemical_list: D019274:Botulinum Toxins, Type A