A novel exaggerated "spino-bulbo-spinal like" reflex of lower brainstem origin

Shabbir Hussain Merchant, Felipe Vial, Giorgio Leodori, Stanley Fahn, Seth L Pullman, Mark Hallett

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Many different oligosynaptic reflexes are known to originate in the lower brainstem which share phenomenological and neurophysiological similarities.

OBJECTIVE: To evaluate and discuss the differences and aberrancies among these reflexes, which are hard to discern clinically using neurophysiological investigations with the help of a case report.

METHODS: We describe the clinical and neurophysiological assessment of a young man who had a childhood history of opsoclonus-myoclonus syndrome with residual mild ataxia and myoclonic jerks in the distal extremities presenting with subacute onset total body jerks sensitive to sound and touch (in a limited dermatomal distribution), refractory to medications.

RESULTS: Based on clinical characteristics and insights gained from neurophysiological testing we could identify a novel reflex of caudal brainstem origin.

CONCLUSIONS: The reflex described is likely an exaggerated normal reflex, likely triggered by a dolichoectatic vertebral arterial compression and shares characteristics of different reflexes known to originate in caudal brainstem, which subserve distinctive roles in human postural control.

Original languageEnglish
Pages (from-to)34-38
Number of pages5
JournalParkinsonism and Related Disorders
Publication statusPublished - Apr 2019


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