[Myorhythmia emerging on day 15 in a case of an infarction in the midbrain-pontine tegmentum]

Rinsho Shinkeigaku. 2007 Aug;47(8):507-11.
[Article in Japanese]

Abstract

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.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Brain Stem Infarctions / complications*
  • Female
  • Hallucinations / etiology
  • Humans
  • Hypertrophy / etiology
  • Mesencephalon / blood supply*
  • Olivary Nucleus / pathology
  • Ophthalmoplegia / etiology
  • Pons / blood supply*
  • Tegmentum Mesencephali / blood supply*
  • Tremor / etiology*