ABSTRACT
A 34 years old male, presenting with progressive proximal weakness, with a neurogenic pattern on needle EMG, and a family history suggestive of an autosomal recessive disorder, was found to have additional features of myeloneuropathy and a down beat nystagmus. A low serum vitamin B12 level was found, and on vitamin B12 supplementation there was a partial clinical as well as electrophysiological recovery.
Subject(s)
Nystagmus, Pathologic/etiology , Vitamin B 12 Deficiency/complications , Adult , Electromyography , Humans , Male , Muscle, Skeletal/physiopathology , Muscular Atrophy, Spinal/complications , Neural Conduction/physiology , Spinal Nerves/physiopathology , Vitamin B 12 Deficiency/diagnosis , Vitamin B 12 Deficiency/therapyABSTRACT
PURPOSE: To describe the Clinical and Surface EMG characteristics of Valproate induced Tremors. Sodium Valproate is known to produce tremors as a side effect. We analyzed clinical and surface electromyographic characteristics of tremors in epileptic subjects who presented with tremors while on sodium valproate. METHODS: Neurological examination and surface electromyographic recordings were performed on 20 subjects with sodium valproate induced tremors. Surface electromyographic tremerogram was correlated with clinical presentation of tremors. RESULTS: This study revealed sodium valproate induced tremors involving primarily upper limbs symmetrically. In the present study, all patients presented with action postural tremors except two, who had tremors in the resting position as well. None of these patients had tremors in goal-directed position. The tremors typically were of high frequency (mean 10 Hz), low amplitude, short burst duration and synchronous burst pattern (Synchronous EMG activity in the agonist and antagonistic muscles). CONCLUSIONS: Frequency, amplitude, burst duration and burst pattern of sodium valproate induced tremors resembles benign essential tremors on surface electromyographic recordings.
