Involuntary rhythmic leg movements time-locked with the respiratory cycle

Pediatr Neurol. 2001 Nov;25(5):405-8. doi: 10.1016/s0887-8994(01)00327-7.

Abstract

Involuntary rhythmic leg movements in childhood is an uncommon condition, the generators of which remain unknown. We report on a male 3 years of age with distinct features providing important clues concerning the location of one of these generators. At the age of 7 months, the previously healthy young male started with low frequency, rhythmic, and continuous (both during wakefulness and sleep) flexion/extension movements of the lower limbs. Movements interfered significantly with gait acquisition, and, despite normal cognitive development, he was able to walk only at age 2 years, 4 months. The neurologic examination revealed the absence of automatic stepping in the neonatal period, but was otherwise normal. A polygraphic electroencephalogram/electromyogram (EEG/EMG) recording, at the age of 2 years, 9 months, revealed rhythmic and synchronous legs with EMG activity at 0.5 Hz. A more complete polygraphic recording at the age of 3 years, 10 months, showed a lower frequency (0.35 Hz) for the movements, which were time-locked with the respiratory cycle. Magnetic resonance imaging (MRI) of the brain revealed an increased T(2) signal in the upper medulla-lower pons regions. The generator of the rhythmic legs movements is postulated to be the respiratory center, connecting with the reticulospinal projecting neurons through an aberrant pathway.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Dyskinesias / congenital
  • Dyskinesias / physiopathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Leg / innervation
  • Magnetic Resonance Imaging
  • Male
  • Medulla Oblongata / pathology
  • Medulla Oblongata / physiopathology*
  • Muscle, Skeletal / innervation
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Neurologic Examination
  • Pons / pathology
  • Pons / physiopathology*
  • Pulmonary Ventilation / physiology*
  • Respiratory Center / pathology
  • Respiratory Center / physiopathology*
  • Spinal Cord / pathology
  • Spinal Cord / physiopathology