Clonic perseveration following thalamofrontal disconnection: a distinctive movement disorder.
Identifieur interne : 004673 ( PubMed/Corpus ); précédent : 004672; suivant : 004674Clonic perseveration following thalamofrontal disconnection: a distinctive movement disorder.
Auteurs : V S Fung ; J G Morris ; J. Leicester ; Y S Soo ; L. DaviesSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1997.
English descriptors
- KwdEn :
- Aged, Basal Ganglia (physiopathology), Brain Diseases (complications), Brain Diseases (physiopathology), Cerebral Infarction (complications), Female, Humans, Intracranial Aneurysm (complications), Intracranial Aneurysm (surgery), Male, Middle Aged, Movement Disorders (diagnosis), Movement Disorders (etiology), Movement Disorders (physiopathology), Neural Pathways, Thalamus, Tomography, X-Ray Computed.
- MESH :
- complications : Brain Diseases, Cerebral Infarction, Intracranial Aneurysm.
- diagnosis : Movement Disorders.
- etiology : Movement Disorders.
- physiopathology : Basal Ganglia, Brain Diseases, Movement Disorders.
- surgery : Intracranial Aneurysm.
- Aged, Female, Humans, Male, Middle Aged, Neural Pathways, Thalamus, Tomography, X-Ray Computed.
Abstract
We describe four patients who developed asymmetrical, rhythmic, stereotyped, and repetitive movements of the upper and lower limbs hours to days after infarction that involved the thalamus and/or basal ganglia. The movements appeared to occur spontaneously and were initially labeled as focal motor seizures, ballism, or tremor; they could however, be induced by passive movement of the limbs. The movements most commonly observed were scratching or rubbing movements of the hands that were of such persistence as to cause trauma to the skin; in the lower limbs, the heel was run up and down the bed sheet, often until it bled. The movements were part of a syndrome characterised initially by a reduced level of consciousness and followed by aspontaneity, usually with mutism and frontal release signs. One patient who had relatively preserved cognition and language repeated words or phrases again and again when encouraged to speak, but had no difficulty changing responses appropriately to different cues. In drawing, he overwrote each figure but could change the figure on command. The distinctive movement disorder in these patients was due to clonic perseveration. We suggest that clonic perseveration results from disconnection of prefrontal cortico-basal ganglia-thalamo-cortical loops that are important for the termination of motor plans. Clonic perseveration should be recognised as a movement disorder following thalamic lesions.
DOI: 10.1002/mds.870120317
PubMed: 9159733
Links to Exploration step
pubmed:9159733Le document en format XML
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<author><name sortKey="Morris, J G" sort="Morris, J G" uniqKey="Morris J" first="J G" last="Morris">J G Morris</name>
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<author><name sortKey="Leicester, J" sort="Leicester, J" uniqKey="Leicester J" first="J" last="Leicester">J. Leicester</name>
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<author><name sortKey="Soo, Y S" sort="Soo, Y S" uniqKey="Soo Y" first="Y S" last="Soo">Y S Soo</name>
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<author><name sortKey="Davies, L" sort="Davies, L" uniqKey="Davies L" first="L" last="Davies">L. Davies</name>
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<author><name sortKey="Morris, J G" sort="Morris, J G" uniqKey="Morris J" first="J G" last="Morris">J G Morris</name>
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<author><name sortKey="Leicester, J" sort="Leicester, J" uniqKey="Leicester J" first="J" last="Leicester">J. Leicester</name>
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<author><name sortKey="Soo, Y S" sort="Soo, Y S" uniqKey="Soo Y" first="Y S" last="Soo">Y S Soo</name>
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<term>Cerebral Infarction (complications)</term>
<term>Female</term>
<term>Humans</term>
<term>Intracranial Aneurysm (complications)</term>
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<term>Humans</term>
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<front><div type="abstract" xml:lang="en">We describe four patients who developed asymmetrical, rhythmic, stereotyped, and repetitive movements of the upper and lower limbs hours to days after infarction that involved the thalamus and/or basal ganglia. The movements appeared to occur spontaneously and were initially labeled as focal motor seizures, ballism, or tremor; they could however, be induced by passive movement of the limbs. The movements most commonly observed were scratching or rubbing movements of the hands that were of such persistence as to cause trauma to the skin; in the lower limbs, the heel was run up and down the bed sheet, often until it bled. The movements were part of a syndrome characterised initially by a reduced level of consciousness and followed by aspontaneity, usually with mutism and frontal release signs. One patient who had relatively preserved cognition and language repeated words or phrases again and again when encouraged to speak, but had no difficulty changing responses appropriately to different cues. In drawing, he overwrote each figure but could change the figure on command. The distinctive movement disorder in these patients was due to clonic perseveration. We suggest that clonic perseveration results from disconnection of prefrontal cortico-basal ganglia-thalamo-cortical loops that are important for the termination of motor plans. Clonic perseveration should be recognised as a movement disorder following thalamic lesions.</div>
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<Abstract><AbstractText>We describe four patients who developed asymmetrical, rhythmic, stereotyped, and repetitive movements of the upper and lower limbs hours to days after infarction that involved the thalamus and/or basal ganglia. The movements appeared to occur spontaneously and were initially labeled as focal motor seizures, ballism, or tremor; they could however, be induced by passive movement of the limbs. The movements most commonly observed were scratching or rubbing movements of the hands that were of such persistence as to cause trauma to the skin; in the lower limbs, the heel was run up and down the bed sheet, often until it bled. The movements were part of a syndrome characterised initially by a reduced level of consciousness and followed by aspontaneity, usually with mutism and frontal release signs. One patient who had relatively preserved cognition and language repeated words or phrases again and again when encouraged to speak, but had no difficulty changing responses appropriately to different cues. In drawing, he overwrote each figure but could change the figure on command. The distinctive movement disorder in these patients was due to clonic perseveration. We suggest that clonic perseveration results from disconnection of prefrontal cortico-basal ganglia-thalamo-cortical loops that are important for the termination of motor plans. Clonic perseveration should be recognised as a movement disorder following thalamic lesions.</AbstractText>
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