Bilateral myoclonus of the trapezius muscles after distal lesion of an accessory nerve
Identifieur interne : 005695 ( Main/Exploration ); précédent : 005694; suivant : 005696Bilateral myoclonus of the trapezius muscles after distal lesion of an accessory nerve
Auteurs : Franz X. Glocker [Allemagne] ; Deuschl [Allemagne] ; Benedikt Volk [Allemagne] ; Joachim Hasse [Allemagne] ; Carl H. Lücking [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 1996-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Traumatisme.
English descriptors
- KwdEn :
- Accessory Nerve (physiopathology), Attitude, Cicatrix (complications), Cicatrix (surgery), Electromyography, Human, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Muscle, Skeletal (physiopathology), Myoclonus, Myoclonus (physiopathology), Neurons, Afferent, Periodicity, Peripheral Nerves (physiopathology), Peripheral Nerves (ultrastructure), Peripheral myoclonus, Peripheral nerve, Peripheral nerve lesion, Spinal cord disease, Spinal myoclonus, Thoracic Injuries (complications), Thorax, Trapezius muscle, Trauma.
- MESH :
- complications : Cicatrix, Thoracic Injuries.
- physiopathology : Accessory Nerve, Muscle, Skeletal, Myoclonus, Peripheral Nerves.
- surgery : Cicatrix.
- ultrastructure : Peripheral Nerves.
- Electromyography, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neurons, Afferent, Periodicity.
Abstract
Observations of rhythmic or semirhythmic myoclonus due to a peripheral nerve lesion are exceptional. We report on a patient with thorax trauma with multiple bilateral hematomas of the paravertebral musculature. Eight years later he developed rhythmic myoclonus of both trapezius muscles and thoracic pain. Infiltration of a paramedially located scar at the level of D5–6 with a local anesthetic agent led to an intermittent relief of the myoclonus as did anesthetic blockade of the left accessory nerve. Surgical excision of the scar, which contained multiple dystrophic axons on histological examination, cured the patient's symptoms as illustrated in a videotape. This indicates that peripheral afferents contributed to the myoclonus. Ephaptic transmission, ectopic excitation, or misdirected neuronal sprouting secondary to the trauma are possible peripheral mechanisms responsible for the movement disorder. Successful blockade of the left accessory nerve with bilateral relief of the symptoms suggests a secondary, more centrally located mechanism, e.g., in the brain stem, probably driven by an altered afferent input. It is concluded that rhythmic or semirhythmic and focal myoclonus need a careful workup to look for a peripheral cause because such a condition would be accessible for surgical treatment.
Url:
DOI: 10.1002/mds.870110514
Affiliations:
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Le document en format XML
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We report on a patient with thorax trauma with multiple bilateral hematomas of the paravertebral musculature. Eight years later he developed rhythmic myoclonus of both trapezius muscles and thoracic pain. Infiltration of a paramedially located scar at the level of D5–6 with a local anesthetic agent led to an intermittent relief of the myoclonus as did anesthetic blockade of the left accessory nerve. Surgical excision of the scar, which contained multiple dystrophic axons on histological examination, cured the patient's symptoms as illustrated in a videotape. This indicates that peripheral afferents contributed to the myoclonus. Ephaptic transmission, ectopic excitation, or misdirected neuronal sprouting secondary to the trauma are possible peripheral mechanisms responsible for the movement disorder. Successful blockade of the left accessory nerve with bilateral relief of the symptoms suggests a secondary, more centrally located mechanism, e.g., in the brain stem, probably driven by an altered afferent input. It is concluded that rhythmic or semirhythmic and focal myoclonus need a careful workup to look for a peripheral cause because such a condition would be accessible for surgical treatment.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Fribourg-en-Brisgau</li></region><settlement><li>Fribourg-en-Brisgau</li></settlement></list><tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Glocker, Franz X" sort="Glocker, Franz X" uniqKey="Glocker F" first="Franz X." last="Glocker">Franz X. Glocker</name></region><name sortKey="Deuschl" sort="Deuschl" uniqKey="Deuschl" last="Deuschl">Deuschl</name><name sortKey="Hasse, Joachim" sort="Hasse, Joachim" uniqKey="Hasse J" first="Joachim" last="Hasse">Joachim Hasse</name><name sortKey="Lucking, Carl H" sort="Lucking, Carl H" uniqKey="Lucking C" first="Carl H." last="Lücking">Carl H. Lücking</name><name sortKey="Volk, Benedikt" sort="Volk, Benedikt" uniqKey="Volk B" first="Benedikt" last="Volk">Benedikt Volk</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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