Segmental myoclonus and basilar artery giant aneurysm case report

Mattos, J. Pitágoras de; Rosso, Ana L. Zuma de; Zayen, Eduardo; Novis, Sérgio A. P.

doi:10.1590/S0004-282X1992000400019

Abstracts

A 70 years-old man was admitted at our hospital because of unstable angina pectoris. He had essential hypertension and right hemiplegia from a ischemic stroke two years before admission. On neurologic examination, it was found mental disorientation, unstable emotionality, right spastic hemiparesis with right Babinski sign, and segmental myoclonus affecting the superior lip and the palate (palatal nystagmus) on the right side. On the CT scan, a giant aneurysm of the basilar artery was detected. We conclude that the segmental myoclonus could be explained by ischemic lesions in the Guillain - Mollaret triangle.

segmental myoclonus; palatal nystagmus; basilar artery aneurysm

Os autores se referem ao caso de um homem de 70 anos, hipertenso e coronariopata, que apresentara, dois anos antes, hemiplegia direita como consequência de acidente vascular encefálico isquêmico. O exame neurológico, na vigência da internação hospitalar, mostrou desorientação espacial, instabilidade emocional (choro imotivado), hemiplegia com sinal de Babinski à direita e mioclonia segmentar comprometendo o lábio superior e o palato (nistagmo palatal) à direita. A tomografia computadorizada do crânio revelou aneurisma gigante da artéria basilar. Concluimos que a mioclonia segmentar poderia estar relacionada às lesões isquêmicas no triângulo de Guillain-Mollaret.

mioclonia segmentar; nistagmo palatal; aneurisma da artéria basilar

J. Pitágoras de Mattos^I; Ana L. Zuma de Rosso^II; Eduardo Zayen^II; Sérgio A. P. Novis^III

^IAssociated Professor. Departmment of Neurology, Clementino Fraga Filho University Hospital (HUCFF-UFRJ), Rio de Janeiro

^IINeurologist. Departmment of Neurology, Clementino Fraga Filho University Hospital (HUCFF-UFRJ), Rio de Janeiro

^IIIHead of the Service of Neurology. Departmment of Neurology, Clementino Fraga Filho University Hospital (HUCFF-UFRJ), Rio de Janeiro

SUMMARY

A 70 years-old man was admitted at our hospital because of unstable angina pectoris. He had essential hypertension and right hemiplegia from a ischemic stroke two years before admission. On neurologic examination, it was found mental disorientation, unstable emotionality, right spastic hemiparesis with right Babinski sign, and segmental myoclonus affecting the superior lip and the palate (palatal nystagmus) on the right side. On the CT scan, a giant aneurysm of the basilar artery was detected. We conclude that the segmental myoclonus could be explained by ischemic lesions in the Guillain - Mollaret triangle.

Key words: segmental myoclonus, palatal nystagmus, basilar artery aneurysm.

RESUMO

Os autores se referem ao caso de um homem de 70 anos, hipertenso e coronariopata, que apresentara, dois anos antes, hemiplegia direita como consequência de acidente vascular encefálico isquêmico. O exame neurológico, na vigência da internação hospitalar, mostrou desorientação espacial, instabilidade emocional (choro imotivado), hemiplegia com sinal de Babinski à direita e mioclonia segmentar comprometendo o lábio superior e o palato (nistagmo palatal) à direita. A tomografia computadorizada do crânio revelou aneurisma gigante da artéria basilar. Concluimos que a mioclonia segmentar poderia estar relacionada às lesões isquêmicas no triângulo de Guillain-Mollaret.

Palavras-chave: mioclonia segmentar, nistagmo palatal, aneurisma da artéria basilar.

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Dr. James Pitágoras de Mattos Av. São Sebastião 165/101 - 22291 Rio de Janeiro RJ - Brasil. Fax (5521) 2673996.

1. Deuschl G, Mischke G, Schenck E, Schult-Mönting J, Lücking CH. Symptomatic and essential rhythmic palatal myoclonus. Brain 1990, 113:1645-1672.
2. Jankovic J, Pardo R. Segmental myoclonus: clinical and pharmacologic study. Arch Neurol 1986, 43:1025-1031.
3. Kissel P, Schmitt J, Andre JM. Syndromes du tronc cérébral. Encycl Méd Chir Système Nerveux 7-1975, 17039A10, Paris: Editions Techniques, 1975.
4. Lee RG. The pathophysiology of essential tremor. In Marsden CD, Fahn S (eds) : Movement Disorders 2. London: Butterworths, 1987, p 423-437.
5. Patel VM, Jankovic J. Myoclonus. In Appel SH (ed) : Current of Neurology. Chicago: Years Book Med Publ, 1988, p 109-156.
6. Teasdall RD. Posterior fossa arteriovenous aneurysm with occlusion of a vertebral artery. Neurology 1958, 8:571-574.

Segmental myoclonus and basilar artery giant aneurysm case report

Mioclonia segmentar e aneurisma gigante da arteria basilar

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
Dec 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Deuschl G, Mischke G, Schenck E, Schult-Mönting J, Lücking CH. Symptomatic and essential rhythmic palatal myoclonus. Brain 1990, 113:1645-1672.

[2] 2. Jankovic J, Pardo R. Segmental myoclonus: clinical and pharmacologic study. Arch Neurol 1986, 43:1025-1031.

[3] 3. Kissel P, Schmitt J, Andre JM. Syndromes du tronc cérébral. Encycl Méd Chir Système Nerveux 7-1975, 17039A10, Paris: Editions Techniques, 1975.

[4] 4. Lee RG. The pathophysiology of essential tremor. In Marsden CD, Fahn S (eds) : Movement Disorders 2. London: Butterworths, 1987, p 423-437.

[5] 5. Patel VM, Jankovic J. Myoclonus. In Appel SH (ed) : Current of Neurology. Chicago: Years Book Med Publ, 1988, p 109-156.

[6] 6. Teasdall RD. Posterior fossa arteriovenous aneurysm with occlusion of a vertebral artery. Neurology 1958, 8:571-574.