Propriospinal myoclonus: a neurophysiologic analysis

Abstract

We are reporting a neurophysiologic analysis of two patients presenting with thoracoabdominal spontaneous muscle jerks. Polymyographic recordings showed myoclonic bursts with onset in the upper rectus abdominis or lower intercostal muscles followed by rostral propagation to the upper intercostal and caudal propagation to the abdominal muscles by slowly conducting pathways. Jerk-locked back-averaging did not show time-locked cortical or premovement potentials. Peroneal somatosensory evoked response, C-reflex, and intercostal nerve conduction were normal. These findings suggest a generator for the myoclonus in the midthoracic region of the spinal cord with up and down propagation by slowly conducting pathways, such as propriospinal fibers. This type of spinal myoclonus may thus be termed "propriospinal myoclonus," as suggested by Brown et al.