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Grippe T, Chen R. Utility of Neurophysiological Evaluation in Movement Disorders Clinical Practice. Mov Disord Clin Pract 2023; 10:1599-1610. [PMID: 38026509 PMCID: PMC10654828 DOI: 10.1002/mdc3.13856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Quantitative and objective neurophysiological assessment can help to define the predominant phenomenology and provide diagnoses that have prognostic and therapeutic implications for movement disorders. Objectives Evaluate the agreement between initial indications and final diagnoses after neurophysiological evaluations in a specialized movement disorders center. Methods Electrophysiological studies conducted for movement disorders from 2003 to 2021 were reviewed. The indications were classified according to predominant phenomenology and the diagnoses categorized in subgroups of phenomenology. Results A total of 509 studies were analyzed. 51% (259) of patients were female, with a mean age of 51 years (ranges 5 to 89 years). The most common reasons for referral were evaluation of functional movement disorders (FMD), followed by jerky movements, tremor and postural instability. Regarding FMD referrals, there was a diagnostic change in 13% of the patients after electrophysiological assessment. The patients with jerky movements as indication had a diagnosis other than myoclonus in 27% of them, and tremor was not confirmed in 20% of the cases. In patients with an electrophysiological diagnosis of FMD, it was not suspected in 30% of the referrals. Similarly, tremor was not mentioned in the referral of 17% of the patients with this electrophysiological diagnosis and myoclonus was not suspected in 13% of the cases. Conclusions Electrophysiological assessment has utility in the evaluation of movement disorders, even in patients evaluated by movement disorders neurologists. More studies are needed to standardize the protocols between centers and to promote the availability and use of these techniques among movement disorders clinics.
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Affiliation(s)
- Talyta Grippe
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHNTorontoOntarioCanada
- Division of NeurologyUniversity of TorontoTorontoOntarioCanada
- Neuroscience Graduate ProgramFederal University of Minas GeraisBelo HorizonteBrazil
| | - Robert Chen
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHNTorontoOntarioCanada
- Neuroscience Graduate ProgramFederal University of Minas GeraisBelo HorizonteBrazil
- Krembil Brain InstituteTorontoOntarioCanada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA)TorontoOntarioCanada
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2
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Vellieux G, Apartis E, Degos V, Fossati P, Navarro V. Effectiveness of electroconvulsive therapy in Lance-Adams syndrome. Brain Stimul 2023; 16:647-649. [PMID: 36935000 DOI: 10.1016/j.brs.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/13/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
- Geoffroy Vellieux
- Paris Brain Institute, ICM, Inserm, CNRS, Sorbonne Université, F-75013, Paris, France; AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, Paris, France
| | - Emmanuelle Apartis
- Paris Brain Institute, ICM, Inserm, CNRS, Sorbonne Université, F-75013, Paris, France; AP-HP, Neurophysiology Department, Saint-Antoine Hospital, Paris, France
| | - Vincent Degos
- AP-HP, Neurosurgical Intensive Care Unit, Pitié-Salpêtrière Hospital, Paris, France; Clinical Research Group 29, Sorbonne Université, Paris, France
| | - Philippe Fossati
- Paris Brain Institute, ICM, Inserm, CNRS, Sorbonne Université, F-75013, Paris, France; AP-HP, Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Vincent Navarro
- Paris Brain Institute, ICM, Inserm, CNRS, Sorbonne Université, F-75013, Paris, France; AP-HP, Epilepsy Unit, Pitié-Salpêtrière Hospital, Paris, France.
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Putative Role of the Lung-Brain Axis in the Pathogenesis of COVID-19-Associated Respiratory Failure: A Systematic Review. Biomedicines 2022; 10:biomedicines10030729. [PMID: 35327531 PMCID: PMC8944980 DOI: 10.3390/biomedicines10030729] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 01/08/2023] Open
Abstract
The emergence of SARS-CoV-2 and its related disease caused by coronavirus (COVID-19) has posed a huge threat to the global population, with millions of deaths and the creation of enormous social and healthcare pressure. Several studies have shown that besides respiratory illness, other organs may be damaged as well, including the heart, kidneys, and brain. Current evidence reports a high frequency of neurological manifestations in COVID-19, with significant prognostic implications. Importantly, emerging literature is showing that the virus may spread to the central nervous system through neuronal routes, hitting the brainstem and cardiorespiratory centers, potentially exacerbating the respiratory illness. In this systematic review, we searched public databases for all available evidence and discuss current clinical and pre-clinical data on the relationship between the lung and brain during COVID-19. Acknowledging the involvement of these primordial brain areas in the pathogenesis of the disease may fuel research on the topic and allow the development of new therapeutic strategies.
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4
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Tai YC, Kuo HC, Wu Y, Hsu SP. Orthostatic myoclonus - A retrospective study of Asian patients. J Formos Med Assoc 2021; 121:1310-1316. [PMID: 34656403 DOI: 10.1016/j.jfma.2021.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/10/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND/PURPOSE Orthostatic myoclonus (OM) is myoclonic jerks in both legs during standing. It may relate to gait unsteadiness and may be associated with various diagnoses, including neurodegenerative, systemic, and musculoskeletal diseases. Diagnosis is based on the surface electromyography (SEMG). METHODS From January 2016 to June 2020, we retrospectively reviewed 35 patients diagnosed with OM based on the SEMG criteria and analyzed the electrophysiological data. RESULTS The mean age was 75.3±8.9. Disease duration ranged from 2 days to several years. Genders were equally affected. The most common symptom was gait disturbance, and the next was leg tremulous sensation, followed by backward disequilibrium. 28.6% of our patients had falls. Electrophysiologically, bursting duration shorter than 100 ms supported the myoclonic origin from the cortex. The bursting activity occurred only on the upright and weight-bearing leg. The associated diagnoses included lumbosacral radiculopathy (28.6%), lumbosacral radiculopathy plus myasthenia gravis (2.9%), lumbosacral radiculopathy plus vascular parkinsonism (5.7%), diabetic polyneuropathy (5.7%), vascular parkinsonism (17.1%), Parkinson's disease (PD) (14.2%), normal pressure hydrocephalus (5.7%), medication-induced parkinsonism (2.9%), cervical myelopathy (2.9%), medication-related myoclonus (2.9%), and unknown (11.4%). In PD, OM was present before, along with, or after PD diagnosis. The myoclonic activity disrupted the parkinsonian tremor upon standing on SEMG. CONCLUSION OM is a syndrome instead of a diagnosis. It is more prevalent in the elderly with gait disturbance and patients will not necessarily fall. It is associated with central and peripheral nerve system disorders, systemic diseases, and medication use. We hypothesize that OM is a pathological disintegration of motor circuit.
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Affiliation(s)
- Yi-Cheng Tai
- Department of Neurology, E-DA Hospital /I-Shou University, Kaohsiung, Taiwan
| | - Hung-Chang Kuo
- Department of Neurology, E-DA Cancer Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Yihui Wu
- Department of Infectious Diseases, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Shih-Pin Hsu
- Department of Neurology, E-DA Hospital /I-Shou University, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan.
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5
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Hu G, Yuan N, Pan Y, Wang B, Wang X, Wang Z, Chen Z, Liu Y. Electroclinical Features of Sleep-Related Head Jerk. Nat Sci Sleep 2021; 13:2113-2123. [PMID: 34880695 PMCID: PMC8646951 DOI: 10.2147/nss.s331893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
STUDY OBJECTIVES To evaluate clinical and electrophysiological features of sleep-related head jerk (SRHJ) and electromyographic activity of superficial neck muscles during head jerk. METHODS Totally, 850 cases with video-polysomnography recording were collected, among which 50 presented with SRHJ. In these 50 patients, 15 underwent electromyography (EMG) check on bilateral sternocleidomastoid (SCM) and trapezius muscles as well as chin, while 35 had only chin EMG check. Further, the sensitivity and specificity of the both EMGs were calculated and compared. RESULTS Six among the 50 SRHJ patients had a primary complaint of involuntary head jerks associated with impaired sleep. Approximately 76.1% of head jerks occurred during REM sleep with the median head jerk index of 5.9/h, 64.5% of which were associated with electroencephalogram arousals and 66.4% with body movements. One patient showed SRHJ predominantly in NREM sleep but also in wakefulness. Surface EMG of SCM/trapezius muscles showed a sensitivity of 92% and a specificity of 97.8%, whereas chin EMG had a sensitivity of 14.5% and a specificity of 98.8%. CONCLUSION SRHJ was associated with electroencephalogram arousals and might interfere with sleep. Surface EMG of SCM/trapezius muscles exhibited a good accuracy in the revelation of SRHJ.
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Affiliation(s)
- Gengyao Hu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China.,Department of Neurology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, 710061, People's Republic of China
| | - Na Yuan
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Yuanhang Pan
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Bi Wang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Xiaoli Wang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Zezhi Wang
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Ze Chen
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, 710032, People's Republic of China
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Yang L, Su Q, Xu N, Xu L, Zhao J, Fan C, Li Y, Li B. Continuous epileptic negative myoclonus as the first seizure type in atypical benign epilepsy with centrotemporal spikes. Medicine (Baltimore) 2020; 99:e22965. [PMID: 33126368 PMCID: PMC7598858 DOI: 10.1097/md.0000000000022965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To figure out which diagnosis is more suitable and which antiepileptic drugs are more sensitive to epileptic negative myoclonus (ENM) as the first seizure type in atypical benign epilepsy with centrotemporal spikes.We reviewed the electroencephalogram (EEG) database of Linyi People's Hospital Affiliated to Shandong University and medical records of patients with ENM onset. The characteristics of epileptic seizures, onset age, treatment process, growth and development history, past disease history, family history, degree of mental deterioration, cranial imaging, and video-EEG were studied retrospectively and followed up.There were 4 cases with ENM onset and 1 with continuous ENM, 3 males and 1 female. The onset age was from 2 years 3 months to 8 years 7 months. The cranial magnetic resonance imaging (MRI) and developmental quotient, as well as the family, personal, and past disease history, were normal. Frequent falls and drops were the main clinical manifestations. Five months after the onset of ENM, case 1 had focal seizures in sleep. ENM was the first and only manifestation in all the other 3 children. Discharges of interictal EEG were in bilateral rolandic areas, especially in midline areas (Cz, Pz), electrical status epilepticus in sleep was found in 3 cases. One child was sensitive to levetiracetam, the other 3 were sensitive to clonazepam.ENM can affect the upper or lower extremities. ENM as the first or only symptom was a special phenomenon in benign epilepsy with centrotemporal spikes (BECTS) variants. Ignorance of midline spikes mainly in Cz or Pz in BECTS might lead to missed diagnosis of ENM. Whether benzodiazepines are viable as a choice of BECTS variants with electrical status epilepticus in sleep when ENM is the first symptom still needs a large sample evidence-based observation.
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Affiliation(s)
- Li Yang
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan
| | - Quanping Su
- Central Laboratory, Linyi People's Hospital Affiliated to Shandong University
| | - Na Xu
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
| | - Liyun Xu
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
- Department of Pediatrics, Shandong Medical College, Linyi, Shandong, People's Republic of China
| | - Juan Zhao
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
| | - Chao Fan
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
| | - Yufen Li
- Department of Pediatrics, Linyi People's Hospital Affiliated to Shandong University, Linyi
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan
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7
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Grippe T, Cunha NSCD, BrandÃo PRDP, Fernandez RNM, Cardoso FEC. How can neurophysiological studies help with movement disorders characterization in clinical practice? A review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:512-522. [PMID: 32901697 DOI: 10.1590/0004-282x20190195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. OBJECTIVE We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. METHODS Non-systematic review of the literature published up to June 2019. RESULTS A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. CONCLUSION These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.
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Affiliation(s)
- Talyta Grippe
- Centro Universitário de Brasília, Faculdade de Medicina, Brasília DF, Brazil.,Hospital de Base do Distrito Federal, Departamento de Neurologia, Brasília DF, Brazil
| | | | | | | | - Francisco Eduardo Costa Cardoso
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Unidade de Distúrbios do Movimento, Belo Horizonte MG, Brazil
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8
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van der Veen S, Zutt R, Klein C, Marras C, Berkovic SF, Caviness JN, Shibasaki H, de Koning TJ, Tijssen MAJ. Nomenclature of Genetically Determined Myoclonus Syndromes: Recommendations of the International Parkinson and Movement Disorder Society Task Force. Mov Disord 2019; 34:1602-1613. [PMID: 31584223 PMCID: PMC6899848 DOI: 10.1002/mds.27828] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/09/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022] Open
Abstract
Genetically determined myoclonus disorders are a result of a large number of genes. They have wide clinical variation and no systematic nomenclature. With next-generation sequencing, genetic diagnostics require stringent criteria to associate genes and phenotype. To improve (future) classification and recognition of genetically determined movement disorders, the Movement Disorder Society Task Force for Nomenclature of Genetic Movement Disorders (2012) advocates and renews the naming system of locus symbols. Here, we propose a nomenclature for myoclonus syndromes and related disorders with myoclonic jerks (hyperekplexia and myoclonic epileptic encephalopathies) to guide clinicians in their diagnostic approach to patients with these disorders. Sixty-seven genes were included in the nomenclature. They were divided into 3 subgroups: prominent myoclonus syndromes, 35 genes; prominent myoclonus syndromes combined with another prominent movement disorder, 9 genes; disorders that present usually with other phenotypes but can manifest as a prominent myoclonus syndrome, 23 genes. An additional movement disorder is seen in nearly all myoclonus syndromes: ataxia (n = 41), ataxia and dystonia (n = 6), and dystonia (n = 5). However, no additional movement disorders were seen in related disorders. Cognitive decline and epilepsy are present in the vast majority. The anatomical origin of myoclonus is known in 64% of genetic disorders: cortical (n = 34), noncortical areas (n = 8), and both (n = 1). Cortical myoclonus is commonly seen in association with ataxia, and noncortical myoclonus is often seen with myoclonus-dystonia. This new nomenclature of myoclonus will guide diagnostic testing and phenotype classification. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sterre van der Veen
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Rodi Zutt
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Samuel F Berkovic
- Epilepsy Research Center, Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
| | - John N Caviness
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Tom J de Koning
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands.,Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University Groningen, University Medical Center Groningen, Groningen, Netherlands
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Abstract
INTRODUCTION Myoclonus is a hyperkinetic movement disorder characterized by sudden, brief, lightning-like involuntary jerks. There are many possible causes of myoclonus and both the etiology and characteristics of the myoclonus are important in securing the diagnosis and treatment. Myoclonus may be challenging to treat, as it frequently requires multiple medications for acceptable results. Few randomized controlled trials investigating the optimal treatment for myoclonus are available, and expert experience and case series guide treatment. Areas Covered: In this article, the authors review the basics of myoclonus and its classification. The authors discuss the current management of myoclonus and then focus on recent updates in the literature, including both pharmacologic and surgical options. Expert opinion: Myoclonus remains a challenge to manage, and there is a paucity of rigorous clinical trials guiding treatment paradigms. Furthermore, due to the etiological heterogeneity of myoclonus, defining the appropriate scope for high-quality clinical trials is challenging. In order to advance the field, the myoclonus study group needs to be revived in the US and abroad so that interested investigators can collaborate on multicenter clinical trials for myoclonus treatments.
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Affiliation(s)
- Christine M Stahl
- a NYU Langone Health , The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, A Parkinson's Foundation Center of Excellence , New York , NY , USA
| | - Steven J Frucht
- a NYU Langone Health , The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, A Parkinson's Foundation Center of Excellence , New York , NY , USA
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10
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Manzke P, Grippe T, Tavares GL, Leal LC, Roze E, Apartis E, Maciel Dias R, Ferreira AGF. Anti-GAD Antibody-associated Syndrome Presenting with Limb Myoclonus. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2019; 8:590. [PMID: 30622836 PMCID: PMC6315060 DOI: 10.7916/d8nk4xvp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/01/2018] [Indexed: 12/05/2022]
Abstract
Background The clinical spectrum of anti-glutamic acid decarboxylase (GAD) antibody-associated neurologic syndromes is expanding, with focal, generalized, and atypical forms. Case Report We describe a 59-year-old female showing continuous right lower limb myoclonus and mild encephalopathy. These symptoms started 2 weeks prior to evaluation. The patient had great improvement with intravenous steroids. An autoantibody panel was positive for anti-GAD. Discussion Various clinical manifestations, including myoclonus, may relate to anti-GAD antibodies. The treatment options available include symptomatic drugs, intravenous immunoglobulin, steroids, and other immunosuppressant agents.
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Affiliation(s)
- Pedro Manzke
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR.,Medicine Department, Centro Universitário de Brasília UNICEUB, Brasília, BR
| | - Talyta Grippe
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR.,Medicine Department, Centro Universitário de Brasília UNICEUB, Brasília, BR
| | - Georgia L Tavares
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR
| | - Lucas C Leal
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR
| | - Emmanuel Roze
- AP-HP, Department of Neurology, Pitié-Salpêtrière Hospital, Paris, FR.,Sorbonne Université, Faculté de Médecine, Institut du Cerveau et de la Moelle Epinière, Paris, FR
| | - Emmanuelle Apartis
- AP-HP, Department of Neurology, Pitié-Salpêtrière Hospital, Paris, FR.,AP-HP, Department of Neurophysiology, Saint-Antoine Hospital, Paris, FR
| | - Ronaldo Maciel Dias
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR
| | - André G F Ferreira
- Department of Neurology, Instituto Hospital de Base do Distrito Federal, Brasília, BR
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Chen J, Zheng G, Guo H, Lu X, Wu C, Wang X, Tao W. Epileptic Negative Myoclonus as the First and Only Symptom in a Challenging Diagnosis of Benign Epilepsy With Centrotemporal Spikes. Child Neurol Open 2017; 4:2329048X17715965. [PMID: 28815192 PMCID: PMC5548311 DOI: 10.1177/2329048x17715965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/15/2017] [Accepted: 03/23/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the clinical and neurophysiological characteristics of epileptic negative myoclonus as the first and only ictal symptom of benign epilepsy with centrotemporal spikes. METHODS Electrophysiological evaluations included polygraphic recordings with simultaneous video electroencephalogram monitoring and tests performed with patient's upper limb outstretched in standing posture. Epileptic negative myoclonus manifestations, electrophysiological features, and responses to antiepileptic drugs were analyzed. RESULTS The authors report 2 patients with benign epilepsy with centrotemporal spikes, who had epileptic negative myoclonus as the first and only seizure type. Video electroencephalogram monitoring results showed that their negative myoclonus seizures were emanating from the contralateral central and the parietal regions. Epileptic negative myoclonus was controlled by administration of valproate and levetiracetam. CONCLUSION Epileptic negative myoclonus can be the first and only seizure type of benign epilepsy with centrotemporal spikes, and long-term follow-up monitoring should be the care for the recurrence and/or presence of other types of seizures.
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Affiliation(s)
- Jing Chen
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Guo Zheng
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Hu Guo
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Xiaopeng Lu
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Chunfeng Wu
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Xiaoyu Wang
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
| | - Wei Tao
- Neurology department, Children's Hospital of Nanjing Medical University, Gulou District, Nanjing, People's Republic of China
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