ABSTRACT
A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek's disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself. He was a Dutch businessman who is often acknowledged as the first microscopist and microbiologist. He disagreed with his physician who attributed his ailment as being of cardiac origin. Diaphragmatic flutter is a rare disorder that requires a high index of suspicion with symptoms including abnormal abdominal wall movements, dyspnoea and respiratory distress. Despite medical treatment, the patient was still highly symptomatic, so she is currently being considered for a phrenic nerve crush.
Subject(s)
Diaphragm/physiopathology , Myoclonus/complications , Respiratory Insufficiency/complications , Aged , Cerebellum/diagnostic imaging , Female , Fluoroscopy , History, 17th Century , History, 18th Century , Humans , Myoclonus/etiology , Myoclonus/history , Respiratory Insufficiency/etiology , Respiratory Insufficiency/history , Stroke/complications , Stroke/pathologyABSTRACT
This review examines some of the advances in understanding myoclonus over the last 25 years. The classification of myoclonus into cortical, brainstem, and spinal forms has been consolidated, each with distinctive clinical characteristics and physiological mechanisms. New genetic causes of myoclonus have been identified, and the molecular basis of several of these conditions has been discovered. It is increasingly apparent that disease of the cerebellum is particularly important in the genesis of cortical reflex myoclonus. However, the precise mechanism and origin of myoclonus in many situations remain uncertain. Effective treatment of myoclonus remains limited, and the challenge lies ahead to develop more therapeutic options.
Subject(s)
Myoclonus , Animals , History, 20th Century , History, 21st Century , Humans , Myoclonus/history , Myoclonus/pathology , Myoclonus/therapyABSTRACT
Symptomatic palatal tremor is caused by a lesion in the triangle of Guillain and Mollaret and is associated with hypertrophic olivary degeneration that has multiple causes. Essential palatal tremor has no currently demonstrable cause and no accompanying physical or radiological signs. But it is probable that an organic genesis will become apparent. I suggest that some examples of palatal tremor may depend on an 'upper motor neurone type', i.e. supranuclear, lesion in the striatum or rostral brainstem releasing medullary activation with denervation hypersensitivity of olivary neurones.
Subject(s)
Myoclonus/etiology , Myoclonus/history , Myoclonus/physiopathology , Aged , History, 19th Century , Humans , MaleABSTRACT
This article reviews the first account of diaphragmatic flutter, published by Antony van Leeuwenhoek, the renowned microscopist, in 1723. The completeness of the clinical description merits the eponymous description of Leeuwenhoek's disease.
Subject(s)
Diaphragm/physiopathology , Myoclonus/physiopathology , Respiratory Insufficiency/etiology , Famous Persons , History, 17th Century , History, 18th Century , Humans , Myoclonus/history , Respiratory Insufficiency/diagnosisSubject(s)
Myoclonus/history , Animals , England , History, 20th Century , Humans , Myoclonus/classification , Myoclonus/therapy , Neurology/historySubject(s)
Myoclonus/history , Seizures/history , History, 19th Century , History, 20th Century , Humans , RhombencephalonABSTRACT
The term myoclonus is a shortened form of the name paramyoklonus multiplex used by Nikolaus Friedreich to describe the involuntary movements of a patient whom today would be said to have a form of essential myoclonus. The details of this case and Friedreich's discussion of it have been reviewed. Other early cases and the initial classification scheme of H. Lundborg have been described.
