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Left hemibody myoclonus due to anomalous right vertebral artery

Authors

  • Miguel Coelho MD,

    1. Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clinic Malalties del Sistema Nervios, Hospital Clínic Universitari, University of Barcelona, Spain
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  • Maria J. Marti MD,

    Corresponding author
    1. Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clinic Malalties del Sistema Nervios, Hospital Clínic Universitari, University of Barcelona, Spain
    • Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clinic Malaltias del Sistema Nervios, Escala 8, planta 4, Hospital Clínic Universitari, Villarroel, 170, Barcelona 08036, Spain

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  • Josep Valls-Solé MD,

    1. EMG Unit, Neurology Service, Institut Clinic Malaltias del Sistema Nervios, Hospital Clínic Universitari, University of Barcelona, Spain
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  • Teresa Pujol MD,

    1. Neuroradiology Department, Hospital Clínic Universitari, University of Barcelona, Spain
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  • Eduardo Tolosa MD

    1. Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clinic Malalties del Sistema Nervios, Hospital Clínic Universitari, University of Barcelona, Spain
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Abstract

A 43-year-old man presented with sporadic, sudden, brief, and involuntary jerks of his left limbs and trunk muscles. The electromyographic recordings showed short-lasting highly synchronized bursts, compatible with myoclonus limited to the left hemibody. Blink reflex, masseter silent period, cortical and spinal magnetic stimulation, somatosensory cortical evoked potentials, and electroencephalogram (EEG) were normal; the EEG back-averaging showed no spikes preceding the myoclonus. Magnetic resonance imaging and magnetic resonance angiography showed the presence of an anomalous nonectasic right vertebral artery compressing the right side of ventral medulla oblongata. We hypothesize that the aberrant right vertebral artery induced abnormal activation of descending motor tracts responsible for the myoclonus. © 2004 Movement Disorder Society

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