Pseudoathetosis  

Oleh:

Yew, Long Lo ; Ikizler, T. Alp

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 363 no. 19 (Nov. 2010), page 363:e29.
Topik: Control Hands
Fulltext: Pseudoathetosis.flv (2.67MB)

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Perpustakaan FK Nomor Panggil: N08.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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An otherwise healthy 40-year-old man presented with a 3-week history of paresthesia and inability to control his hands. Physical examination revealed generalized areflexia, marked loss of position sense, loss of feeling in a glove-and-stocking distribution, and preserved motor strength. The patient also had a broad-based gait and dysmetria in all four limbs. Romberg's sign was present. When he stretched out his arms, his fingers showed involuntary, constant, slow writhing movements (see Videos 1 and 2) that became more prominent with eye closure. The movements could also be seen in his toes, although to a lesser extent (Video 3). This pattern of movement is known as “pseudoathetosis.” It is clinically indistinguishable from true athetosis, but pseudoathetosis is caused by loss of proprioception, whereas athetosis is due to structural abnormalities in certain areas of the brain. Pseudoathetosis has been reported in spinal cord disorders but more often occurs in disorders of the central or peripheral nervous system. In this patient, magnetic resonance imaging of the brain and spinal cord and extensive studies of serum and cerebrospinal fluid produced unremarkable results. He was given a diagnosis of idiopathic sensory ataxic neuropathy and received a course of intravenous immune globulin, with no effect. Methylprednisolone was then administered for 5 days, followed by a short tapering course of oral glucocorticoids. He showed a partial recovery 5 months after the initial presentation. At 11 months, there was no further abatement of neurologic signs.

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