Respiratory Myoclonus (Leeuwenhoek's Disease)

Ventilatory Dysfunction in Palatal Myoclonus

“…We postulate that dur ing inspiration a momentary absence of diaphragmatic contraction would occur after each myoclonic burst followed by ex halation (driven by lung elastic recoil). This effect can be seen in figures 2 and 3 of Phillips and Eldridge's [4] paper on 'diaphragmatic flutter'. This explanation, however, does not account for the virtual absence of flow interruption during expi ration in our case, unless it is also postu lated that myoclonic activity of the dia phragm was present only during inspira tion; an unlikely event.…”

“…Some cases of this disorder can be ascribed to unilateral peripheral stimula tion of the phrenic nerve [6], but in others a central disorder is more likely [5]. Phil lips and Eldridge [4] documented electro myographic myoclonic activity of the sca lene and intercostals in synchrony with discharges of the diaphragm in their case of 'diaphragmatic flutter'. They proposed renaming all these manifestations as 'res piratory myoclonus'.…”

“…Both im pressions were challenged by analysis of evidence obtained later. Phrenicectomy has been used in the past to treat diaphrag matic myoclonus [7] even though phenylhydantoin is probably an effective and less hazardous treatment [4]. Bollinger et al [1] believed that tracheostomy would have been beneficial to their patient.…”

A Clinical Approach to Chronic Dyspnea

“…74 Idiopathic asynchronous (paradoxical) breathing resulting from respiratory muscle dyscoordination or diaphragmatic myoclonus can cause dyspnea. 69,72 Spasticity, nonrespiratory dyskinesias, and ataxia, especially if coupled with deconditioning, can produce significant dyspnea as a result of the high-energy costs associated with activity (eg, multiple sclerosis, hemiplegia, spastic spinal paralysis, cerebellar ataxia). 25,75 …”

Non–Rapid Eye Movement Sleep Parasomnias

“…These include segmental myoclonus, such as palatal myoclonus [234,235] or diaphragmatic flutter [236][237][238], and paroxysmal dystonia [239]. Respiratory dyskinesias also may be the manifestation of neuroleptic-induced dyskinesias and may or may not persist during sleep [240][241][242][243].…”