[Skeletal and velar myoclonus with vision disorders. Efficacy of carbamazepine]. / Myoclonies squelettiques et du voile avec troubles visuels. Efficacité de la carbamazépine.

The authors report the case of a 71 year-old woman presenting right velopharyngo-laryngeal and skeletal rhythmic myoclonus, associated with visual and phasic disorders. They appeared four months after an infarct in the region of the left posterior cerebral artery. The ischemia was of temporo-occipital location, very probably extending to the region of the left red nucleus, thereby interrupting the dento-olivary pathway. Several drugs which are usually active in the treatment of myoclonus proved ineffective. But carbamazepine at a dose of 600 mg per day was effective from the third day and remained so after seven months. It would seem to act by inhibiting the occurrence of paroxystic discharges of an epileptic type in the olivary body disinhibited by the underlying lesion.

[Hemiballism caused by metastasis to Luys' body]. / Hémiballisme par métastase du corps de Luys.

A 66 year-old man suddenly developed a left-sided hemiballism. CT scan revealed 3 metastases, one of them in the area of the right subthalamic nucleus (corpus Luysii). A primary lung tumor was suspected. Haloperidol and tiapride were unsuccessful to control the hemiballism. The patient died 5 months later. Pathological examination confirmed the diagnosis. The pathophysiology of this case is discussed with regard to the pathological findings. Hemiballism secondary to a metastasis is rare, 9 cases have been reported during the past 65 years. Vascular lesions are the usual cause (75 per cent); on rare occasions degenerative disorders (14 per cent), destructive (tumors: 10 per cent or surgical lesions: 0,3-9 per cent) can also result in hemiballism.