Neonatal-onset brainstem reticular reflex myoclonus following a prenatal brain insult: Generalized myoclonic jerk and a brainstem lesion

Yosuke Kakisaka, Kazuhiro Haginoya, Noriko Togashi, Taro Kitamiura, Mitsugu Uematsu, Naomi Hino-Fukuyo, Shigeo Kure, Junko Saito, Setsuko Kitaoka, Shuei Watanabe, Hideto Yoshikawa, Takahiro Nara, Yoichi Suzuki, Shigeru Tsuchiya

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)303-308
Number of pages6
JournalTohoku Journal of Experimental Medicine
Volume211
Issue number3
DOIs
Publication statusPublished - 2007 Mar 9

Keywords

  • Brainstem lesion
  • Brainstem reticular reflex myoclonus
  • Prenatal brain insult
  • Stimulus-sensitive generalized clonic movement

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Fingerprint Dive into the research topics of 'Neonatal-onset brainstem reticular reflex myoclonus following a prenatal brain insult: Generalized myoclonic jerk and a brainstem lesion'. Together they form a unique fingerprint.

  • Cite this

    Kakisaka, Y., Haginoya, K., Togashi, N., Kitamiura, T., Uematsu, M., Hino-Fukuyo, N., Kure, S., Saito, J., Kitaoka, S., Watanabe, S., Yoshikawa, H., Nara, T., Suzuki, Y., & Tsuchiya, S. (2007). Neonatal-onset brainstem reticular reflex myoclonus following a prenatal brain insult: Generalized myoclonic jerk and a brainstem lesion. Tohoku Journal of Experimental Medicine, 211(3), 303-308. https://doi.org/10.1620/tjem.211.303