Reflex reticular myoclonus: relationship to some brainstem pathophysiological mechanisms.

Abstract

Two patients with reflex reticular myoclonus [RRM] were tested electrophysiologically and pharmacologically. In one of the cases the underlying disease was chronic Lyme borreliosis. In the other, the RRM attacks may have been associated with procarbazine therapy applied for Hodgkin's disease. No cortical lesion could be demonstrated either clinically or electrophysiologically [EEG, averaged EEg preceeding the jerks, SSEP]. An EMG analysis of the jerks revealed the shortest latency in the muscles innervated by the accessory nerve. The latencies became longer in a more rostral muscle [masseter], as well as in a more caudal one, the muscles innervated by the facial nerve were spared. it is presumed that the complete movement pattern of the myoclonus residues in the jerk generating structure. RRM in the described cases differs from the startle by sparing the facial nerve and from the Papio papio baboon non-epileptic myoclonus by the activating effect of physostigmine. A partial therapeutic effect was achieved with a serotonine precursor, but a GABAergic therapy proved to be the most effective.

• Authors: I Rektor, Z Kadanka, J Bednarik
• Journal: Acta neurologica Scandinavica (Acta Neurol Scand) Vol. 83 Issue 4 Pg. 221-5 (Apr 1991) ISSN: 0001-6314 [Print] Denmark
• PMID: 2048395 (Publication Type: Case Reports, Journal Article)

Chemical References

• Physostigmine
• Phenobarbital

Topics

• Adult
• Brain Stem (physiopathology)
• Electroencephalography
• Electromyography
• Hodgkin Disease (complications)
• Humans
• Male
• Middle Aged
• Myoclonus (complications, physiopathology)
• Phenobarbital
• Physostigmine
• Reflex, Abnormal (drug effects)
• Reflex, Startle (drug effects)
• Reticular Formation (drug effects, physiopathology)