A novel exaggerated "spino-bulbo-spinal like" reflex of lower brainstem origin.
Acoustic Stimulation
Adult
Ataxia
/ etiology
Brain Stem
/ diagnostic imaging
Cognitive Dysfunction
/ etiology
Electromyography
Humans
Male
Myoclonus
/ etiology
Opsoclonus-Myoclonus Syndrome
/ complications
Physical Stimulation
Reflex, Abnormal
/ physiology
Reflex, Startle
/ physiology
Touch
Vertebral Artery
Vertebrobasilar Insufficiency
/ complications
Jerk-like movements
Myoclonus
Physiology
Reflex
Startle
Journal
Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
19
08
2018
revised:
02
10
2018
accepted:
04
10
2018
pubmed:
15
10
2018
medline:
6
5
2020
entrez:
15
10
2018
Statut:
ppublish
Résumé
Many different oligosynaptic reflexes are known to originate in the lower brainstem which share phenomenological and neurophysiological similarities. To evaluate and discuss the differences and aberrancies among these reflexes, which are hard to discern clinically using neurophysiological investigations with the help of a case report. We describe the clinical and neurophysiological assessment of a young man who had a childhood history of opsoclonus-myoclonus syndrome with residual mild ataxia and myoclonic jerks in the distal extremities presenting with subacute onset total body jerks sensitive to sound and touch (in a limited dermatomal distribution), refractory to medications. Based on clinical characteristics and insights gained from neurophysiological testing we could identify a novel reflex of caudal brainstem origin. The reflex described is likely an exaggerated normal reflex, likely triggered by a dolichoectatic vertebral arterial compression and shares characteristics of different reflexes known to originate in caudal brainstem, which subserve distinctive roles in human postural control.
Sections du résumé
BACKGROUND
Many different oligosynaptic reflexes are known to originate in the lower brainstem which share phenomenological and neurophysiological similarities.
OBJECTIVE
To evaluate and discuss the differences and aberrancies among these reflexes, which are hard to discern clinically using neurophysiological investigations with the help of a case report.
METHODS
We describe the clinical and neurophysiological assessment of a young man who had a childhood history of opsoclonus-myoclonus syndrome with residual mild ataxia and myoclonic jerks in the distal extremities presenting with subacute onset total body jerks sensitive to sound and touch (in a limited dermatomal distribution), refractory to medications.
RESULTS
Based on clinical characteristics and insights gained from neurophysiological testing we could identify a novel reflex of caudal brainstem origin.
CONCLUSIONS
The reflex described is likely an exaggerated normal reflex, likely triggered by a dolichoectatic vertebral arterial compression and shares characteristics of different reflexes known to originate in caudal brainstem, which subserve distinctive roles in human postural control.
Identifiants
pubmed: 30316728
pii: S1353-8020(18)30435-8
doi: 10.1016/j.parkreldis.2018.10.007
pmc: PMC6451678
mid: NIHMS1509395
pii:
doi:
Types de publication
Case Reports
Journal Article
Research Support, N.I.H., Intramural
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
34-38Subventions
Organisme : Intramural NIH HHS
ID : Z99 NS999999
Pays : United States
Informations de copyright
Copyright © 2018 Elsevier Ltd. All rights reserved.
Références
Mov Disord. 2003 Aug;18(8):906-11
pubmed: 12889080
J Clin Neurophysiol. 2001 Jul;18(4):378-85
pubmed: 11673704
J Neurophysiol. 1967 Mar;30(2):319-32
pubmed: 6045198
Clin Neurol Neurosurg. 1983;85(1):71-2
pubmed: 6303666
Brain. 1991 Aug;114 ( Pt 4):1891-902
pubmed: 1884184
Bull Los Angeles Neurol Soc. 1981;46:41-50
pubmed: 7052912
Brain Dev. 2011 Apr;33(4):335-8
pubmed: 20591595
No To Shinkei. 1963 Dec;15:1165-72
pubmed: 14099662
Adv Neurol. 1995;67:273-87
pubmed: 8848974
Neurology. 1979 Aug;29(8):1107-25
pubmed: 572498
Neurology. 2000 Nov 14;55(9):1381-4
pubmed: 11087786
Brain Res. 1972 Jan 28;36(2):307-31
pubmed: 5009641
Electroencephalogr Clin Neurophysiol. 1997 Dec;105(6):476-83
pubmed: 9448650
Nihon Seirigaku Zasshi. 1967;29(7):324-5
pubmed: 5625357
J Neurol Neurosurg Psychiatry. 1977 Mar;40(3):253-64
pubmed: 301926
Calif Med. 1949 May;70(5):382
pubmed: 18120858
Brain. 1991 Aug;114 ( Pt 4):1903-28
pubmed: 1884185
Ann Neurol. 1992 Jul;32(1):41-50
pubmed: 1642471
Nihon Seirigaku Zasshi. 1971 Apr;33(4):225-33
pubmed: 4326340
Adv Neurol. 2002;89:153-9
pubmed: 11968441
Clin Neurophysiol. 2012 Jan;123(1):34-44
pubmed: 22033030
Arch Neurol. 1996 Jul;53(7):608-13
pubmed: 8929168
Jpn J Physiol. 1964 Aug 15;14:411-21
pubmed: 14200821
Epilepsia. 2012 Dec;53 Suppl 7:3-11
pubmed: 23153204
Acta Neurol Scand. 1999 Apr;99(4):255-9
pubmed: 10225359
Neurology. 2014 Nov 11;83(20):1862-70
pubmed: 25305154
Brain Nerve. 2010 Apr;62(4):365-9
pubmed: 20420176
Shinkei Kenkyu No Shimpo. 1967 Oct;11(3):452-7
pubmed: 4873136