Clinical diagnosis of propriospinal myoclonus is unreliable: an electrophysiologic study.
Identifieur interne : 000A67 ( Main/Exploration ); précédent : 000A66; suivant : 000A68Clinical diagnosis of propriospinal myoclonus is unreliable: an electrophysiologic study.
Auteurs : Roberto Erro [Royaume-Uni] ; Kailash P. Bhatia ; Mark J. Edwards ; Simon F. Farmer ; Carla CordivariSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2013.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Myoclonus.
- physiology : Contingent Negative Variation.
- physiopathology : Spinal Cord.
- statistics & numerical data : Databases, Factual.
- Cohort Studies, Electroencephalography, Electromyography, Female, Humans, Male.
Abstract
Propriospinal myoclonus is a rare movement disorder that is hypothesized to arise from a spinal generator that transmits activity up and down the spinal cord via long propriospinal pathways. Polymyography is mandatory for the diagnosis, but the typical electrophysiological pattern described for propriospinal myoclonus has been also found in patients with psychogenic axial jerks, supported by the presence of a Bereitschaftspotential (BP; from German, "readiness potential," also called the premotor potential). We evaluated polymyographic findings in 65 patients referred to us with a clinical diagnosis of propriospinal myoclonus and also looked for the presence of the BP, as detected by jerk-locked back-averaging. At clinical reassessment by a movement disorder specialist, nearly one-half of the patients had clinical clues suggestive of a psychogenic cause of the jerks. Electrophysiological studies were carried out on all 65 patients. Polymyography findings revealed an incongruent electromyographic pattern for propriospinal myoclonus in 84.6% of patients and the presence of the BP in 86.1% of the entire cohort. When taking into account either the presence of BP and/or incongruence of polymyographic features, all patients, including the approximately 50% clinically diagnosed as organic propriospinal myoclonus by a movement disorder expert, had strong neurophysiological evidence for a psychogenic origin of their jerks. The clinical distinction of propriospinal myoclonus from psychogenic axial jerks is unreliable. This is the largest cohort of patients with axial jerks reported so far and we suggest that most of the patients with a clinical picture that clinically resembles propriospinal myoclonus are likely to be psychogenic.
DOI: 10.1002/mds.25627
PubMed: 24105950
Affiliations:
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Bhatia</name></author><author><name sortKey="Edwards, Mark J" sort="Edwards, Mark J" uniqKey="Edwards M" first="Mark J" last="Edwards">Mark J. Edwards</name></author><author><name sortKey="Farmer, Simon F" sort="Farmer, Simon F" uniqKey="Farmer S" first="Simon F" last="Farmer">Simon F. Farmer</name></author><author><name sortKey="Cordivari, Carla" sort="Cordivari, Carla" uniqKey="Cordivari C" first="Carla" last="Cordivari">Carla Cordivari</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:24105950</idno><idno type="pmid">24105950</idno><idno type="doi">10.1002/mds.25627</idno><idno type="wicri:Area/PubMed/Corpus">000762</idno><idno type="wicri:Area/PubMed/Curation">000762</idno><idno type="wicri:Area/PubMed/Checkpoint">000A77</idno><idno type="wicri:Area/Ncbi/Merge">003D35</idno><idno type="wicri:Area/Ncbi/Curation">003D35</idno><idno type="wicri:Area/Ncbi/Checkpoint">003D35</idno><idno type="wicri:Area/Main/Merge">000A67</idno><idno type="wicri:Area/Main/Curation">000A67</idno><idno type="wicri:Area/Main/Exploration">000A67</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical diagnosis of propriospinal myoclonus is unreliable: an electrophysiologic study.</title><author><name sortKey="Erro, Roberto" sort="Erro, Roberto" uniqKey="Erro R" first="Roberto" last="Erro">Roberto Erro</name><affiliation wicri:level="3"><nlm:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name></author><author><name sortKey="Edwards, Mark J" sort="Edwards, Mark J" uniqKey="Edwards M" first="Mark J" last="Edwards">Mark J. Edwards</name></author><author><name sortKey="Farmer, Simon F" sort="Farmer, Simon F" uniqKey="Farmer S" first="Simon F" last="Farmer">Simon F. Farmer</name></author><author><name sortKey="Cordivari, Carla" sort="Cordivari, Carla" uniqKey="Cordivari C" first="Carla" last="Cordivari">Carla Cordivari</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cohort Studies</term><term>Contingent Negative Variation (physiology)</term><term>Databases, Factual (statistics & numerical data)</term><term>Electroencephalography</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Male</term><term>Myoclonus (diagnosis)</term><term>Spinal Cord (physiopathology)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Myoclonus</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Contingent Negative Variation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Spinal Cord</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Databases, Factual</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cohort Studies</term><term>Electroencephalography</term><term>Electromyography</term><term>Female</term><term>Humans</term><term>Male</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Propriospinal myoclonus is a rare movement disorder that is hypothesized to arise from a spinal generator that transmits activity up and down the spinal cord via long propriospinal pathways. Polymyography is mandatory for the diagnosis, but the typical electrophysiological pattern described for propriospinal myoclonus has been also found in patients with psychogenic axial jerks, supported by the presence of a Bereitschaftspotential (BP; from German, "readiness potential," also called the premotor potential). We evaluated polymyographic findings in 65 patients referred to us with a clinical diagnosis of propriospinal myoclonus and also looked for the presence of the BP, as detected by jerk-locked back-averaging. At clinical reassessment by a movement disorder specialist, nearly one-half of the patients had clinical clues suggestive of a psychogenic cause of the jerks. Electrophysiological studies were carried out on all 65 patients. Polymyography findings revealed an incongruent electromyographic pattern for propriospinal myoclonus in 84.6% of patients and the presence of the BP in 86.1% of the entire cohort. When taking into account either the presence of BP and/or incongruence of polymyographic features, all patients, including the approximately 50% clinically diagnosed as organic propriospinal myoclonus by a movement disorder expert, had strong neurophysiological evidence for a psychogenic origin of their jerks. The clinical distinction of propriospinal myoclonus from psychogenic axial jerks is unreliable. This is the largest cohort of patients with axial jerks reported so far and we suggest that most of the patients with a clinical picture that clinically resembles propriospinal myoclonus are likely to be psychogenic.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Bhatia, Kailash P" sort="Bhatia, Kailash P" uniqKey="Bhatia K" first="Kailash P" last="Bhatia">Kailash P. Bhatia</name><name sortKey="Cordivari, Carla" sort="Cordivari, Carla" uniqKey="Cordivari C" first="Carla" last="Cordivari">Carla Cordivari</name><name sortKey="Edwards, Mark J" sort="Edwards, Mark J" uniqKey="Edwards M" first="Mark J" last="Edwards">Mark J. Edwards</name><name sortKey="Farmer, Simon F" sort="Farmer, Simon F" uniqKey="Farmer S" first="Simon F" last="Farmer">Simon F. Farmer</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Erro, Roberto" sort="Erro, Roberto" uniqKey="Erro R" first="Roberto" last="Erro">Roberto Erro</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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