Neonatal-Onset Brainstem Reticular Reflex Myoclonus Following a Prenatal Brain Insult: Generalized Myoclonic Jerk and a Brainstem Lesion
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Accession number;07A0229892
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| Title;Neonatal-Onset Brainstem Reticular Reflex Myoclonus Following a Prenatal Brain Insult: Generalized Myoclonic Jerk and a Brainstem Lesion |
| Author;
KAKISAKA YOSUKE
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
HAGINOYA KAZUHIRO
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
TOGASHI NORIKO
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
KITAMIURA TARO
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
UEMATSU MITSUGU
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
HINO-FUKUYO NAOMI
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
KURE SHIGEO
(Department of Medical Genetics, Tohoku University Graduate School of Medicine)
SAITO JUNKO
(Department of Pediatrics, Tohoku Kosei Nenkin Hospital)
KITAOKA SETSUKO
(Department of Pediatrics, Tohoku Kosei Nenkin Hospital)
WATANABE SHUEI
(Department of Neurology, Miyagi Children's Hospital)
YOSHIKAWA HIDETO
(Department of Neurology, Miyagi Children's Hospital)
NARA TAKAHIRO
(Department of Rehabilitation, Miyagi Children's Hospital)
SUZUKI YOICHI
(Department of Public Health, Chiba University Graduate School of Medicine)
TSUCHIYA SHIGERU
(Department of Pediatrics, Tohoku University Graduate School of Medicine)
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Journal Title;Tohoku J Exp Med
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Journal Code:G0649A
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ISSN:0040-8727
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VOL.211;NO.3;PAGE.303-308 (J-STAGE)(2007)
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| Figure&Table&Reference; |
| Pub. Country;Japan |
| Language;English |
| Abstract;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. (Author abst.) |
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