Document Detail


Neonatal-onset brainstem reticular reflex myoclonus following a prenatal brain insult: generalized myoclonic jerk and a brainstem lesion.
MedLine Citation:
PMID:  17347557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Brainstem reticular reflex myoclonus (BRRM) is characterized by sudden, generalized, shock-like movements that can be elicited by sensory stimulation. We present a boy, born after 35 weeks gestation, who was diagnosed with neonatal-onset BRRM. Within 1 hr of birth, the patient showed spasticity and generalized clonic movements of all limbs elicited with tactile stimulation anywhere on the body. Surface electromyography showed co-contraction of agonistic and antagonistic muscles, revealing that his generalized clonic movements were tremulous myoclonus in nature. Brain magnetic resonance imaging (MRI) at 21 hrs after birth disclosed high-intensity lesions in the Rolandic area, thalamus, basal ganglia, and brainstem, including the dorsal pons and medulla, the center of BRRM, in T1-weighted images. Follow-up MRI at 1 month revealed dramatic improvement in the pontine lesion. The patient showed gradual remission of the characteristic movements, which disappeared at 1 year of age, but the patient died unexpectedly at 1 year and 3 months. In conclusion, neonatal BRRM arises as a result of severe brainstem injury, and the associated lesions may only be seen temporarily on MRI taken soon after birth.
Authors:
Yosuke Kakisaka; Kazuhiro Haginoya; Noriko Togashi; Taro Kitamiura; Mitsugu Uematsu; Naomi Hino-Fukuyo; Shigeo Kure; Junko Saito; Setsuko Kitaoka; Shuei Watanabe; Hideto Yoshikawa; Takahiro Nara; Yoichi Suzuki; Shigeru Tsuchiya
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  211     ISSN:  0040-8727     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  303-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Tohoku University Graduate School of Medicine, and Tohoku Kosei Nenkin Hospital, Sendai, Japan. kakisuke@mui.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Electromyography
Fatal Outcome
Humans
Infant, Newborn
Magnetic Resonance Imaging
Male
Myoclonus / etiology*,  pathology*
Prenatal Injuries / pathology*
Reflex, Abnormal*
Reticular Formation / injuries*

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