Unusual focal dyskinesias: The ears, the shoulders, the back, and the abdomen

Abstract

Fourteen patients with focal or segmental involuntary movements affecting the ears, back, shoulder girdle, and upper extremity, as well as the abdomen and pelvic girdle, are presented. The unusual locations and appearance of these dyskinesias distinguishes them from recognized movement disorder syndromes. It is argued that the slow, sinuous, and semirhythmic character of the movements and the variable long-duration bursts of motor unit activity responsible for them most closely fit into the spectrum of dystonia. A history of pain in the affected region and/or peripheral trauma in some cases also suggests that peripheral factors may play a role in their pathogenesis.

Late-Onset PANDAS Syndrome with Abdominal Muscle Involvement

“…The abnormal movements observed in the present case can be classified as isolated or semirhythmic myoclonic abdominal bursts with a variable distribution pattern. These hyperkinesias were different from the sinus movements characterizing the belly dancer dyskinesia described by Iliceto et al [5] or from the repetitive rhythmic jerks and oscillations recorded by Caviness et al [6]. Furthermore, we failed to detect any stimulus sensitiveness as described by Kono et al [7] (belly dance myoclonus).…”

Posttraumatic Focal Dystonia of the Shoulder

“…Isolated dystonia of the shoulder has only rarely been reported in the literature, occurring either as rhythmic intermittent movements or as a fixed posture with shoulder elevation and marked hypertrophy especially of the trapezius muscle [3, 4]. However, shoulder muscles are often involved in sporadic and posttraumatic instances of cervical (segmental) dystonia [1, 5, 6, 7, 8].…”

“…In conclusion, we describe a dynamic abnormal shoulder posture with circumscribed trapezius muscle hypertrophy following a minor peripheral trauma. Since no indication of pseudodystonia after musculosceletal injury could be found, we consider the disorder to represent true dystonia, which classically shows sustained muscle contractions leading to repetitive twisting movements or abnormal postures and at least partial improvement with a geste antagoniste [1, 3, 4]. …”

Propriospinal myoclonus: The spectrum of clinical and neurophysiological phenotypes

“…The syndrome may be idiopathic or occur after a spinal lesion [63], local trauma or abdominal pain [65,67,68], vitamin B12 deficiency, L-dopa treatment [66], antidopaminergic drugs [69] or pontine myelinolysis [64]. In any case, its overlap with spinal myoclonus [65,70,71] and with functional movement disorders remains unclear and current data are insufficient to categorize this disorder as a discrete clinical entity.…”