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• Vol.47 No.8
• CLINICA NEUROL, 47: 507−511, 2007
• Vol.47 No.8 contents

Case Report

Myorhythmia emerging on day 15 in a case of an infarction in the midbrain-pontine tegmentum

Miho Shinohara, M.D., Shinsui Tatsumi, M.D. and Toru Yamamoto, M.D.

Department of Neurology, Osaka Saiseikai Nakatsu Hospital

A 72-year-old woman was admitted to our hospital because of dysarthria, dysstasia, and diplopia. Examination demonstrated wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome, dysarthria, truncal ataxia, and dysmetria of the four limbs. Cranial MR images demonstrated an acute infarct in the paramedian, lower midbrain-pontine tegmentum. Peduncular hallucinosis was observed during the first several days of hospitalization. Myorhythmia (skeletal myoclonus) appeared as early as day 15 and has persisted to date, with a frequency of approximately 1.5 Hz on the head and chin, and 3.5 Hz on the left upper extremity. Cranial MR images 5 months after onset demonstrated bilateral inferior olivary hypertrophy, while palatal tremor appeared later. Only a limited number of case reports are available in which myorhythmia emerged as early as in our case after the onset of a brain infarct.

(CLINICA NEUROL, 47: 507−511, 2007)
key words: myorhythmia, WEBINO syndrome, peduncular hallucinosis, olivary hypertrophy, tegmentum, infarct

(Received: 9-Apr-07)