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

doi:10.1016/j.parkreldis.2018.10.007

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

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Abstract

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 language	English
Pages (from-to)	34-38
Number of pages	5
Journal	Parkinsonism and Related Disorders
Volume	61
DOIs	https://doi.org/10.1016/j.parkreldis.2018.10.007
Publication status	Published - Apr 2019

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10.1016/j.parkreldis.2018.10.007

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title = "A novel exaggerated {"}spino-bulbo-spinal like{"} reflex of lower brainstem origin",

abstract = "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.",

author = "Merchant, {Shabbir Hussain} and Felipe Vial and Giorgio Leodori and Stanley Fahn and Pullman, {Seth L} and Mark Hallett",

year = "2019",

month = apr,

doi = "10.1016/j.parkreldis.2018.10.007",

language = "English",

volume = "61",

pages = "34--38",

journal = "Parkinsonism and Related Disorders",

issn = "1353-8020",

publisher = "Elsevier BV",

}

TY - JOUR

T1 - A novel exaggerated "spino-bulbo-spinal like" reflex of lower brainstem origin

AU - Merchant, Shabbir Hussain

AU - Vial, Felipe

AU - Leodori, Giorgio

AU - Fahn, Stanley

AU - Pullman, Seth L

AU - Hallett, Mark

PY - 2019/4

Y1 - 2019/4

N2 - 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.

AB - 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.

U2 - 10.1016/j.parkreldis.2018.10.007

DO - 10.1016/j.parkreldis.2018.10.007

M3 - Article

C2 - 30316728

SN - 1353-8020

VL - 61

SP - 34

EP - 38

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

ER -

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

Abstract

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