Although the number of case reports and studies regarding propriospinal myoclonus has increased during the past several years in western countries, a single case has not been reported in Korea until now. We report hear our experiences in treating
a
24-year-old female patient who manifested propriospinal myoclonus after being involved in a traffic accident.
Immediately following the accident, the patient developed an axial jerk in the cervical and thoracic areas. Electroencephalography, computerized tomography of the brain and a neurological examination all failed to show evidence of cerebral
pathology.
However, electromyographic recordings revealed spontaneous jerks in the sternocleidomastoid, trapezius, paraspinal, rectus abdominis and quadriceps muscles. Accordingly, we made a diagnosis of propriospinal myoclonus and considered spinal cord
trauma
from the traffic accident as the etiological agent. We treated the patient with anticonvulsants including carbamazepine, sodium valproate and clonazapam. After six months of inpatient treatment, the patient displayed much improvement in myoclonic
movement and was discharged.
Propriospinal myoclonus is a disease in which myoclonic activity is thought to spread up and down the length of the spinal cord via long propriospinal pathways intrinsic to the cord. Diagnosis is seldom possible solely on the basis of clinical
presentation. Comprehensive electrophysiological investigations (including electromyography and imaging studies) are always necessary for a definitive diagnosis. Spinal cord trauma and dural adhesion of any cause are considered the main
etiological
factors in propriospinal myoclonus. The disease may be treated with anticonvulsants such as carbamazepine, sodium valproate and clonazepam.
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