Abstract:
Background: Many different oligosynaptic reflexes are known to
originate in the lower brainstem which share phenomenological and
neurophysiological similarities.
Objective: To evaluate and discuss the differences and aberrancies among
these reflexes, which are hard to discern clinically using
neurophysiological investigations with the help of a case report.
Methods: We describe the clinical and neurophysiological assessment of a
young man who had a childhood history of opsoclonus-myoclonus syndrome
with residual mild ataxia and myoclonic jerks in the distal extremities
presenting with subacute onset total body jerks sensitive to sound and
touch (in a limited dermatomal distribution), refractory to medications.
Results: Based on clinical characteristics and insights gained from
neurophysiological testing we could identify a novel reflex of caudal
brainstem origin.
Conclusions: The reflex described is likely an exaggerated normal reflex,
likely triggered by a dolichoectatic vertebral arterial compression and
shares characteristics of different reflexes known to originate in caudal
brainstem, which subserve distinctive roles in human postural control
