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Annals of Indian Academy of Neurology
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IMAGE IN NEUROLOGY
Year : 2020  |  Volume : 23  |  Issue : 3  |  Page : 356
 

Spinal segmental myoclonus presented as unilateral rotating scapula


1 Department of Neurology, Institute of Human Behavior and Allied Sciences, New Delhi, India
2 Department of Neurology, AMRI Hospitals, Bhubaneswar, Odisha, India

Date of Submission13-Apr-2019
Date of Acceptance22-Apr-2019
Date of Web Publication10-Jun-2020

Correspondence Address:
Dr. Siddharth Maheshwari
Institute of Human Behavior and Allied Sciences, New Delhi - 110 095
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.AIAN_208_19

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How to cite this article:
Kushwaha S, Panda AK, Anthony A, Singh S, Madan D, Maheshwari S. Spinal segmental myoclonus presented as unilateral rotating scapula. Ann Indian Acad Neurol 2020;23:356

How to cite this URL:
Kushwaha S, Panda AK, Anthony A, Singh S, Madan D, Maheshwari S. Spinal segmental myoclonus presented as unilateral rotating scapula. Ann Indian Acad Neurol [serial online] 2020 [cited 2020 Jul 7];23:356. Available from: http://www.annalsofian.org/text.asp?2020/23/3/356/263996




A 62-year-old woman developed spontaneous involuntary rhythmic counterclockwise rotatory movement of the right scapula with a frequency of 2.5–3 Hz [Video 1], which was also present during sleep, without significant medical history. Neurologic examination revealed right scapular movement, absent deep tendon reflexes in both upper limbs, and impaired pain and temperature sensations in C4–C8 dermatome on the right side. Surface electromyography revealed burst of 0.2–0.4 s with interburst interval of 0.4–0.6 s occurring at the rate of 2.5–3 Hz in C2–C6 innervated right periscapular muscles, including rhomboids, trapezius, levator scapulae, and serratus anterior. Electroencephalography (EEG) was normal and back-averaging did not show cortical correlates. Magnetic resonance imaging of the cervical spine suggested syringomyelia extending from cervicomedullary junction to C6 vertebra level [Figure 1]. The postulated mechanism in spinal segmental myoclonus in syringomyelia is due to hyperexcitability of alpha motoneurons resulting from damage of inhibitory interneurons located in the spinal cord gray matter.[1],[2]
Figure 1: (a and b) T1- and T2-weighted Sagittal sequence magnetic resonance imaging of cervical spine showing syringomyelia extending from cervicomedullary junction up to C6 vertebra level (arrow)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Nogués MA. Spontaneous electromyographic activity in spinal cord lesions. Muscle Nerve Suppl 2002;11:S77-82.  Back to cited text no. 1
    
2.
Bagnato S, Rizzo V, Quartarone A, Majorana G, Vita G, Girlanda P, et al. Segmental myoclonus in a patient affected by syringomyelia. Neurol Sci 2001;22:27-9.  Back to cited text no. 2
    


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