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A patient with postanoxic encephalopathy, with both action- and stimulus-sensitive reflex myoclonus, is described. The action myoclonus was multifocal and cortical in origin. In contrast, reflex myoclonus elicited by somaesthetic and auditory stimulation was generalised. The earliest reflex electromyograph activity was recorded in the sternocleidomastoid; myoclonic activity then spread up the brainstem and down the spinal cord, suggesting that this reflex myoclonus had its origin in the caudal brainstem. Stimulus sensitivity was greatest in the limbs. The bulbospinal motor pathways involved in the generalised reflex myoclonus were rapidly conducting, and this characteristic distinguishes this form of brainstem reflex myoclonus from that described in hyperekplexia.

Original publication

DOI

10.1002/mds.870060209

Type

Journal article

Journal

Mov Disord

Publication Date

1991

Volume

6

Pages

139 - 144

Keywords

Aged, Arousal, Brain Mapping, Brain Stem, Cerebral Cortex, Electroencephalography, Electromyography, Epilepsies, Myoclonic, Female, Humans, Hypoxia, Brain, Motor Neurons, Myoclonus, Neck Muscles, Neural Pathways, Reaction Time, Reflex, Startle, Reticular Formation, Spinal Cord