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Query: UMLS:C0027066 (myoclonus)
 4,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

5 patients with cerebral anoxia of various etiology had postanoxic coma with the syndrome of periodic synchronous and sterotyped myoclonus first mentioned by Lance and Adams. These authors observed action myoclonus as a sequel to this syndrome which is rarely survived. Most reports have dealt mainly with its bad prognostic significance. Although the localization of action myoclonus has much been discussed, and is still controversial, little attention has been paid to the possible localizing significance of its acute precursor syndrome. Most patients with this type of myoclonus (all in our series) present a lower pontine/upper oblongata syndrome. The distribution patterns of the jerks are constant, do not represent topographic but functional relationships showing innervation patterns which are presumably integrated in the vestibular system and upper oblongata reticular formation. Interval histograms show that the jerks, unlike those in subacute sclerosing panencephalitis, are not repeated at regular intervals. Several rhythms might be intermingled, or a rhythmic (physiological?) pacemaker could be modified by proprioception of the jerks. The latter possibility is supported by the observation that EEG discharges in one patient became rhythmic when the jerks ceased. The only other instance of rhythmicity was in a very special observation of continuous seesaw alternations of slow jerks of m. levator palpebrae sup., and tonic contractions of m. corrugator glabellae. Rhythmicity in this case had a 1:2 relation to heart rate indicating the nucleus tractus solitarii region as a possible site of origin of the impulses. Our observations indicate an upper oblongata origin for this type of myoclonus. Autopsies in 3 of our cases revealed widespread severe anoxic damage but nothing to add to the pathological localization.
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PMID:Periodic synchronous and stereotyped myoclonus with postanoxic coma. 6 98

Motor phenomena - mostly in the form of myoclonus in the widest sense - are not rare in aeromedical studies conducted at flight altitudes and involving severe and acute hypoxia. At the same time medium to severe general changes can be observed in the EEG. When oxygen is supplied the motor phenomena stop after a few seconds, and the EEG results become normal again. These reversible changes are contrasted with clinical findings after anoxic coma conditions and hypoxic accidents which occurred during flights and where the myoclonus survives the coma, which is an extremely grave prognostic indication.
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PMID:[Prognostic significance of myoclonias in aerospace altitude studies and others with acute hypoxia-accompanied status]. 12 75

The clinical pattern of typhoid fever is changing, and in particular the incidence of neuro-psychiartic manifestations is on the increase. In 246 cases of enteric fever we found 124 with confusional states, delirium, coma, generalized myoclonus, Parkinsonian rigidity or psychoses. We further distinguished two major sub-groups with an acute and an insidious onset. The apparent increase in the frequency of neuro-psychiatric complications of typhoid could represent a change in the pathogenicity of S. typhi or the increasing recognition of a biochemical defect caused by a bacterial endotoxins and provoked by poor nutrition.
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PMID:Neuro-psychiatric manifestations of typhoid. 59 55

We report a 69-year-old patient, a chronic diabetic, who had a cardiac arrest after myocardial infarction. In the state of acute anoxic coma, massive myoclonic jerks occurred, and it was found that myoclonus could be elicited by light touch of the right trigeminal area (but of no other body region). The myoclonus was associated with complex EEG discharges against an almost flat background of activity. Findings of the autopsy showed cerebral edema with bilateral uncal herniation and prominence of the right cerebellar tonsil. Stimulus-sensitive myoclonus based on proprioceptive stimuli has been reported in chronic postanoxic states. This type of somatosensory elicitation seems to be extremely rare. We discuss the neurophysiological substratum; it is presumed that the cortex was still reached by the somatosensory stimuli.
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PMID:Selective stimulus-sensitive myoclonus in acute cerebral anoxia. A case report. 86 Sep 37

A 10 1/2 years old boy fell brutally ill with a fit followed by confusion, and then by deep coma, with 40 degrees C fever and morbilliform rash. Consciousnesse came back within ten days, with transient Parkinson-like tremor. Myoclonus persisted for about six months. Complete recovery was followed up for six years. A diagnosis of encephalitis was considered on early EEG evidence (stereotyped repetitive sharp wave bursts) and was confirmed by isolation of ECHO 5 virus from brain specimen, and ultrastructural observation of characteristic cytopathic effect (disappearance of organelles, proliferation of smooth membranes) and of probable viral particules in astrocytes, without any inflammatory process.
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PMID:[Curable ECHO 5 virus encephalitis. Clinical, electroencephalographic, virologic and ultrastructural study]. 88 30

Although there is evidence that the delirium, stupor, coma, and seizure-like activity seen in overdosage with tricyclic antidepressants and antiparkinson drugs are due to the central anticholinergic activity of these agents, patients with overdosage of these drugs are still frequently misdiagnosed. The authors present a case of reversal of anticholinergic-drug-induced prolonged coma, myoclonus, and choreoathetosis by physostigmine. This report supports the anticholinergic basis of the clinical manifestations of such overdosages, provides information on the role of acetylcholine and dopamine in psychiatric and movement disorders, and illustrates dramatically the need for accurate diagnosis and treatment.
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PMID:Reversal of tricyclic-overdosage-induced central anticholinergic syndrome by physostigmine. 96 21

Three new cases of methyl bromide poisoning (leakage from a fire extinguisher) are reported. Two of these were characterized, after an initial period of coma and myoclonic status, by an action myoclonus. Electrical data are presented. A follow up of 4 and 8 years allowed to study the effect of drugs, two of which (clonazepam and baclofene) being pecularly contributive. The third patient outlived for 5 years in a stuporous state with myoclonus. The anatomical findings consisted mainly of a necrosis of both inferior colliculi with gliosis in the upper brain stem reticular formation and moderate changes in the dentate and pontine nuclei. Their significance is discussed in view of physiological and experimental knowledge.
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PMID:[Methyl bromide poisoning. 3 cases, 1 fatal. Neruopathological study of one case of coma with myoclonus followed for 5 years]. 119 82

Rhythmic palatal myoclonus (RPM) is a rare movement disorder consisting of continuous synchronous jerks of the soft palate, muscles innervated by other cranial nerves and, rarely, trunk and limb muscles. It usually develops secondary to brainstem or cerebellar disease (symptomatic RPM). Some patients, however, fail to show evidence of a structural lesion (essential RPM). A total of 287 cases with RPM from the literature including 210 cases with symptomatic and 77 cases with essential RPM have been reviewed and analysed statistically to look for criteria separating the two conditions. Patients with essential RPM usually have objective earclicks as their typical complaint which is rare in the symptomatic form. Eye and extremity muscles are never involved. The jerk frequency is lower in essential than in symptomatic RPM. Patients with essential RPM are younger and have a balanced sex distribution as compared with a male preponderance in the symptomatic form. The rhythmicity of RPM seems to be more profoundly influenced by sleep, coma and general anaesthesia in essential than in symptomatic RPM. We conclude from these results that essential RPM should be separated as a distinct clinical entity. Symptomatic RPM is a rhythmic movement disorder whose pathogenesis is quite well established. The cells of the hypertrophied inferior olives are believed to represent the oscillator. Among other possibilities, essential RPM may represent its functional analogue, based on transmitter changes only. Such a relationship could be of theoretical interest for the understanding of rhythmic hyperkinesias in general.
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PMID:Symptomatic and essential rhythmic palatal myoclonus. 227 39

A 56-year-old, hypertensive man was admitted to our hospital because of confusion. He had been well unit half an hour before admission, when he had suddenly developed left hemiplegia. Although he became deep coma soon after admission, his vital signs were preserved. CT scan revealed a large right putaminal hemorrhage and a ventricular perforation. The condition was too severe for surgical approaches and conservative therapy for brain edema was performed. On the 2nd hospital day, corneal and light reflexes were disappeared and an anisocolia appeared. On the 3rd hospital day, right papilledema appeared. Doll's head-eye movements and ciliospinal reflexes were absent. CT scan demonstrated marked brain edema and collapsed ambient cisterns. Tentorial herniation were suspected. On the 4th hospital day, respiratory arrest occurred and ventilatory assistance began. On the 11th hospital day, electroencephalograms (EEG's) showed electrocerebral silence. EEG's performed next day showed still electrocerebral silence. On the 13th hospital day, brainstem auditory evoked potentials were recorded without any responses. He was thought to be in condition of brain death. On the 17th hospital day, multifocal myoclonus involving lower limbs and abdominal muscles appeared. The myoclonus lasted for about 15 hours occurred on both sides, but was asymmetrical. The myoclonus consisted of intermittent, brief, arrhythmic, stereotype, jerking contractions of the muscles. Sometimes, the contractions were sufficient enough to jump his body over the bed. These symptoms provided the characteristics of spinal myoclonus. Etiologies of spinal myoclonus are varied, but the primary abnormality exists within the spinal cord.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spinal myoclonus in association with brain death]. 262 31

The triad of mental abnormalities, neurologic disorders and abnormal electroencephalogram is central to respiratory encephalopathy. The development of myoclonus has been considered as a sign heralding the development of generalized seizures and coma. A patient with chronic bronchitis is reported in whom myoclonus was the predominant symptom. Myoclonus was generalized, symmetrical and synchronic, and electroencephalographic correlation was shown, with diffuse polyspike-high potential wave discharges coincident with myoclonus. Remarkably, they promptly responded to low doses of diazepam, with disappearance of clinical neurologic and electrical findings. These have not subsequently relapsed although the patient is not receiving specific therapy. The risk of the administration of diazepam was weighted against other specific drugs (clonacepam, pyracetam) which are probably better tolerated. The interest in the quicker response of diazepam prevailed. We propose the inclusion of myoclonus secondary to respiratory encephalopathy in the classification of myoclonic disorders.
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PMID:[Myoclonus as a manifestation of respiratory encephalopathy]. 263 90


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