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Case Reports
. 2023 May 1;19(5):995-998.
doi: 10.5664/jcsm.10486.

Propriospinal myoclonus: diagnostic value of polymyography and video polysomnography

Rybel Wix Ramos  1   2   3 , Laura López Viñas  4 , Esmeralda Rocio Martín  1 , Cecilia Luque Cárdenas  1 , Adela Fraile Pereda  2 , Lydia López Manzanares  5
Affiliations
Case Reports

Propriospinal myoclonus: diagnostic value of polymyography and video polysomnography

Rybel Wix Ramos et al. J Clin Sleep Med. .

Abstract

Propriospinal myoclonus is a hyperkinetic movement disorder characterized by painless jerks of the axial muscles, mainly in the trunk and hips. A 53-year-old woman was referred to the Sleep Unit with trunk flexion movements in the supine position during the wake-sleep transition and during sleep, with premonitory sensation. We performed 2 video polysomnographic recordings. In the first video polysomnogram, the recording showed jerks of the trunk and abdomen that appeared when the posterior dominant alpha rhythm disappeared; during these jerks the patient stayed at stage 1 or stage 2 of non-rapid eye movement sleep. The second video polysomnogram included several electromyogram electrodes located at the masseter, deltoid, rectus abdominis (T9-T0 level), vastus lateralis, and tibialis anterior muscles. This polysomnogram revealed 123 repetitive arrhythmic jerks with variable duration, usually lasting 500-1,900 ms each (906 ± 0.4 ms). In our patient, propriospinal myoclonus was detected up to stage 2 of non-rapid eye movement sleep and even at rapid eye movement sleep.

Citation: Ramos RW, Viñas LL, Martín ER, Cárdenas CL, Pereda AF, Manzanares LL. Propriospinal myoclonus: diagnostic value of polymyography and video polysomnography. J Clin Sleep Med. 2023;19(5):995-998.

Keywords: axial myoclonus; propriospinal myoclonus; sleep and myoclonus; sleep-related movement disorder; spinal segmental myoclonus.

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Conflict of interest statement

All authors have seen and approved this manuscript. Work for this study was performed at the Department of Clinical Neurophysiology, Sleep Unit, University Hospital “La Princesa”. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. First video polysomnography of propriospinal myoclonus (PSM).
The first segment of the recording shows theta activity with arousal during PSM. (Top) EEG and EMG recordings of 1 spontaneous PSM at sleep onset. (Bottom) EEG activity during PSM, seen in a longitudinal montage. Abd = abdominal bands, Aches = chest band, Chin = submental EMG, Dif 5 = mouth thermistor, ECG = electrocardiogram, EMG = electromyogram, Flow = nasal cannula, Lat = left leg EMG, LOC = left electrooculogram, Osat = oxygen saturation, Pos = body position, PR = pulse rate, Rat = right leg EMG, ROC = right electrooculogram.
Figure 2
Figure 2. Second video polysomnography recording of 1 propriospinal myoclonus (PSM) during stage 1 of NREM sleep (N1) (top), stage 2 of NREM sleep (N2) (middle) and REM sleep (bottom).
The jerk started in the rectus abdominis (Rectus Abd) at T10 level and spread to the deltoid (Delt), vastus lateralis (Vastus) and tibialis anterior (Tib.Ant) muscles. Hypnogram shows the relationship between myoclonic jerks and the sleep-wake cycle. EOG traces (LOC, ROC), EMG submental (Chin), Electrocardiogram (ECG), Mastoid left (A1), and mastoid right (A2). Chin = EMG submental, EMG = electromyogram, EOG = electro-oculogram, LOC, ROC = EOG traces, NREM = non-rapid eye movement.
See this image and copyright information in PMC

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