A novel treatment and diagnostic approach to myoclonus and restless leg syndrome.
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1
Innova Brain Rehabilitation, United States
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2
Carrick Institute for Graduate Studies, United States
Objective: Discuss improvements in myoclonic jerks and restless leg syndrome (RLS) following intensive neuromuscular and vestibular rehabilitation.
Clinical Features: Male subject was 53 years old with a history of myoclonus in his legs, back, and shoulders that began 30-40 years ago with RLS. Upon examination the following was observed: eye-head strategy during pursuits vertically and leftward, irregular optokinetic responses (OKR), square wave jerks throughout videonystagmography (VNG) testing and bedside examination at the same frequency as myoclonic jerks, a fall on dynamic posturography with subject on a perturbed surface with eyes closed and head extended (PSECHE), and myoclonic jerks during muscle stretch reflex (MSR) of the bilateral patella, brachioradialis, and biceps.
Interventions and Outcomes: The subject was seen for a five day period including testing/examination day one, three daily treatment sessions the following four days, and post-treatment evaluation the final day. Vestibular rehabilitation and neuromuscular re-education was implemented in the clinic including gaze stabilization exercises, electrical stimulation procedures, and therapeutic application of light into the left eye from the lateral field. Marked improvement was observed on day five with resolution of eye-head strategy during pursuits, reduced amplitude of myoclonus during percussion of MSRs, improved stability score during dynamic posturography including a change from 0% to 63% with PSECHE, and the subject reported a reduction in restless leg activity. Square wave jerk activity persisted during VNG testing and during bedside examination
Conclusions: Intensive rehabilitation impacted long-standing RLS myoclonus in a male subject’s legs, back, and shoulders. While full resolution was not achieved, the subject demonstrated a significant reduction in frequency and amplitude of jerks after five days of therapy as well as a reduction in activity of restless legs. Further investigation may establish a therapeutic approach with expanding improvements for individuals with hyperkinetic movement disorders.
Keywords:
Myoclonus,
movement disorder,
hyperkinetic movement disorder,
Restless Leg Syndrome,
RLS,
Vestibular Rehabilitation,
Neuromuscular re-education,
Dynamic posturography
Conference:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function, Orlando, United States, 7 Oct - 9 Oct, 2016.
Presentation Type:
Poster Presentation
Topic:
Abstracts ISCN 2016
Citation:
Patterson
FE and
Keiser
ND
(2016). A novel treatment and diagnostic approach to myoclonus and restless leg syndrome..
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function.
doi: 10.3389/conf.fneur.2016.59.00080
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Received:
02 Sep 2016;
Published Online:
07 Sep 2016.
*
Correspondence:
Dr. Frank E Patterson, Innova Brain Rehabilitation, Marietta, GA, United States, fpatterson@innovabrain.com
Dr. Nathan D Keiser, Innova Brain Rehabilitation, Marietta, GA, United States, dockeiser@gmail.com