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Limb myorhythmia from spinal cord glioma
  1. Fabio Fieni Toso1,
  2. Thiago Cardoso Vale2,
  3. José Luiz Pedroso1,
  4. Henrique Ballalai Ferraz1,
  5. Orlando G P Barsottini1
  1. 1 Department of Neurology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  2. 2 Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
  1. Correspondence to Dr José Luiz Pedroso, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; jlpedroso.neuro{at}gmail.com

https://doi.org/10.1136/practneurol-2021-003147

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    A 26-year-old man gave a 4-week history of involuntary movements in the right arm (figure 1), manifesting as slow rhythmic, painless spasms of abduction. He had been previously well. On examination, he had generalised hyperreflexia with bilateral extensor plantar responses. MR scan of the brain, electroencephalogram and nerve conduction studies were normal. Needle electromyography identified bursts of involuntary motor unit activity with an average duration of around 1000 ms (1 Hz) in the right deltoid, biceps and pronator teres muscles. MR scan of cervical spine identified a spinal cord tumefactive lesion at C5–C6 vertebral levels, sparing only the left lateral aspect of the spinal cord, suggesting an intramedullary tumour (figure 2A,B). Following surgical resection, his movements completely resolved. Neuropathology confirmed the lesion to be a spinal cord glioma; immunohistochemistry showed expression of glial fibrillar acidic protein and Ki-67, a nuclear proliferation marker, suggesting it was of …

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    Footnotes

    • Contributors FFT: conception, organisation and execution of the case report project, data collection from the case report, and writing the first draft, reviewing and critiquing the manuscript (nothing to disclose). TCV: organisation and execution of the case report project, and writing the first draft, reviewing and critiquing the manuscript (nothing to disclose). JLP: conception, organisation and execution of the case report project, data collection from the case report, and writing the first draft, reviewing and critiquing the manuscript (nothing to disclose). HBF: conception and organisation of the case report project, data collection from the case report, writing the first draft of the manuscript (nothing to disclose). OGPB: conception, organisation and execution of the case report project, data collection from the case report, and writing the first draft, reviewing and critiquing the manuscript (nothing to disclose).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned. Externally peer reviewed by Monty Silverdale, Manchester, UK.

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