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Focal pathological startle following pontine infarction

Authors

  • Shaun R.D. Watson MB, BS, PhD,

    1. Institute of Neurological Sciences, Department of Neurology and Clinical School, Prince of Wales Hospital, Randwick, Sydney 2031, Australia
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  • James G. Colebatch MB, BS, PhD

    Corresponding author
    1. Institute of Neurological Sciences, Department of Neurology and Clinical School, Prince of Wales Hospital, Randwick, Sydney 2031, Australia
    • Institute of Neurological Sciences, Prince of Wales Hospital, Randwick, Sydney 2031, Australia
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  • A videotape accompanies this article.

Abstract

A 36-year-old male developed an acute right-sided weakness due to left-sided pontine infarction. Two months later, he first noticed sudden right elbow flexion in response to a loud unexpected noise. Detailed electrophysiological assessment was performed. A large, short-latency (median 39 msec), synchronous electromyographic discharge occurred in the right biceps brachii electrodes following a 50-msec, 120-dB 1-kHz tone burst, with habituation only with very short (30-second) interstimulus intervals. Less synchronous activity at longer latencies was present both in a number of right-sided arm muscles at rest and on the clinically unaffected side during a tonic voluntary contraction. We discuss possible underlying mechanisms and our reasons for considering this a focally enhanced startle response. Our report broadens the range of expression of acquired startle disorders. © 2001 Movement Disorder Society.

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