BioMed Central Page 1 of 3 (page number not for citation purposes) Journal of Brachial Plexus and Peripheral Nerve Injury Open Access Case report Spinal myoclonus following a peripheral nerve injury: a case report Feray Karaali Savrun, Derya Uluduz*, Gokhan Erkol and Meral E Kiziltan Address: Department of Neurology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey Email: Feray Karaali Savrun - feraykaraali@yahoo.com; Derya Uluduz* - deryaulu@yahoo.com; Gokhan Erkol - gerkol@superonline.com; Meral E Kiziltan - meralekiziltan@yahoo.com * Corresponding author Abstract Spinal myoclonus is a rare disorder characterized by myoclonic movements in muscles that originate from several segments of the spinal cord and usually associated with laminectomy, spinal cord injury, post-operative, lumbosacral radiculopathy, spinal extradural block, myelopathy due to demyelination, cervical spondylosis and many other diseases. On rare occasions, it can originate from the peripheral nerve lesions and be mistaken for peripheral myoclonus. Careful history taking and electrophysiological evaluation is important in differential diagnosis. The aim of this report is to evaluate the clinical and electrophysiological characteristics and treatment results of a case with spinal myoclonus following a peripheral nerve injury without any structural lesion. Background Myoclonus is defined as a sudden muscular contraction that usually indicates disease of the central nervous sys- tem and may be cortical, subcortical, or spinal in origin [1]. Spinal myoclonus is a rare disorder characterized by myoclonic movements in muscles that originate from sev- eral segments of the spinal cord. Though structural lesions are usually found in spinal myoclonus, the pathophysiol- ogy remains speculative. But there is evidence that various possible mechanisms can be involved: loss of inhibitory function of local dorsal horn interneurons, abnormal hyperactivity of local anterior horn neurons, aberrant local axons re-excitations and loss of inhibition from suprasegmentar descending pathways [2]. This report describes a case with spinal myoclonus follow- ing a peripheral nerve injury. Clinical, electrophysiologi- cal characteristics and treatment results were discussed. Case presentation A 33-year-old female was admitted to Neurology Depart- ment with a complaint of weakness, hypoesthesia, paresis and painless constant involuntary muscle spasms of the left upper extremity. Her complaints started 4 months ago, after she fell upon her left arm. At that time there appeared a collection and oedema on the left arm elbow joint. In a month, she experienced weakness, sensory def- icits and minimal muscle spasms in the left ulnar nerve innervation area. Cervical magnetic resonance imaging (MRI) was normal. Electromyographic evaluation (EMG) revealed a conduction delay and/or a conduction block with a neurogenic involvement displaying partial dener- vation in muscles innervated by ulnar nerve. Collection was evacuated by decompression surgery and ulnar nerve was released. After the operation weakness and sensory deficits did not improve. Involuntary movements in the left ulnar nerve innervated muscles, than increased and spread to the the whole arm. She was referred to our clinic. Published: 6 August 2008 Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:18 doi:10.1186/1749-7221-3-18 Received: 7 January 2008 Accepted: 6 August 2008 This article is available from: http://www.jbppni.com/content/3/1/18 © 2008 Savrun et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.