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Spinal myoclonus is a sudden, brief, and involuntary movement of segmental or propriospinal muscle groups. Spinal myoclonus has occasionally been reported in patients undergoing opioid therapy, but the pathophysiology of opioid-induced myoclonus has not been elucidated yet. Here, we present two patients with spinal segmental myoclonus secondary to ischemic and radiation myelopathy. Conventional medications did not help treat persistent myoclonus in both legs. Continuous intrathecal morphine infusion was implanted for pain control in one patient, which relieved spinal myoclonus entirely. This experience led to the application of this method with a second patient, leading to the same gratifying result. Spinal myoclonus reemerged as soon as the morphine pumps were off, which confirmed the therapeutic role of opioids. In contrast to the opioid-induced myoclonus, these cases show a benefit of opioids on spinal myoclonus, which could be explained by synaptic reorganization after pathologic insults in the spinal cord.
Analgesics, Opioid ; Dyskinesias ; Humans ; Leg ; Methods ; Morphine* ; Myoclonus* ; Spinal Cord ; Spinal Cord Diseases

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Isolated Neurological Manifestation in Silent Celiac Disease.

Salma TARABZOUNI ; Thamer ALKHAIRALLAH

Journal of Movement Disorders.2017;10(2):105-107. doi:10.14802/jmd.16063

No abstract available.
Celiac Disease* ; Neurologic Manifestations*

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Beyond the Classic Segawa Disease, GCH1-Associated Neurodegenerative Parkinsonism: Practical Considerations for Physicians.

Jirat CHENBHANICH ; Jirada SRINGEAN ; Roongroj BHIDAYASIRI

Journal of Movement Disorders.2017;10(2):102-104. doi:10.14802/jmd.17009

No abstract available.
Parkinsonian Disorders*

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Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome.

Zheyu XU ; Kalpana PRASAD ; Tianrong YEO

Journal of Movement Disorders.2017;10(2):99-101. doi:10.14802/jmd.16058

We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS). The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.
Adult ; Autism Spectrum Disorder ; Autistic Disorder ; Creatine Kinase ; Diagnosis ; Encephalomyelitis* ; Humans ; Intellectual Disability ; Male ; Myoclonus* ; Neuroleptic Malignant Syndrome* ; Seizures ; Status Epilepticus

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Paroxysmal Kinesigenic Dyskinesia as the Presenting and Only Manifestation of Multiple Sclerosis after Eighteen Months of Follow-Up.

Marius BAGUMA ; Michel OSSEMANN

Journal of Movement Disorders.2017;10(2):96-98. doi:10.14802/jmd.16055

Other than tremor, movement disorders are uncommon in multiple sclerosis. Among these uncommon clinical manifestations, paroxysmal kinesigenic dyskinesia is the most frequently reported. It is characterized by episodic attacks of involuntary movements that are induced by repetitive or sudden movements, startling noise or hyperventilation. The diagnosis is essentially clinical and based on a good observation of the attacks. It is very easy to misdiagnose it. We describe the case of a young female patient who presented paroxysmal kinesigenic dyskinesia as the first and only clinical manifestation of multiple sclerosis, with no recurrence of attacks nor any other neurologic symptom after eighteen months of follow-up.
Diagnosis ; Dyskinesias* ; Female ; Follow-Up Studies* ; Humans ; Hyperventilation ; Movement Disorders ; Multiple Sclerosis* ; Neurologic Manifestations ; Noise ; Recurrence ; Tremor

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Metronidazole-Induced Craniocervical Myoclonus with Reversible Bilateral Dentate Nucleus Lesions.

Hyun Chang LEE ; Young Eun KIM ; Hyeo Il MA

Journal of Movement Disorders.2017;10(1):67-68. doi:10.14802/jmd.16021

No abstract available.
Cerebellar Nuclei* ; Myoclonus*

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Multifocal Myoclonus as a Manifestation of Acute Cerebral Infarction Recovered by Carotid Arterial Stenting.

Hyangkyoung KIM ; Jun Soo BYUN ; Mark HALLETT ; Hae Won SHIN

Journal of Movement Disorders.2017;10(1):64-66. doi:10.14802/jmd.16040

No abstract available.
Cerebral Infarction* ; Myoclonus* ; Stents*

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Camptocormia with Transient Ischemic Attack.

Ju Hee OH ; Dong Woo RYU ; Si Hoon LEE ; Joong Seok KIM

Journal of Movement Disorders.2017;10(1):62-63. doi:10.14802/jmd.16043

No abstract available.
Ischemic Attack, Transient*

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