Objective: To review the clinical and electrophysiological characteristics of orthostatic myoclonus (OM) in the setting of brain tumor treatment, a novel association.

Background: OM is a recently described cause of gait unsteadiness whereby predominantly lower limb myoclonus is provoked by assumption of an upright posture. OM typically affects the elderly and is associated with neurodegenerative diseases more often than not.

Methods: The database of the Mayo Clinic Rochester Movement Disorders Laboratory was searched for all patients diagnosed with OM from January 2007 to December 2016. All available clinical, radiographic, and surface electromyographic data were reviewed, keeping only those patients with a history of primary or metastatic brain tumor for further analysis.

Results: Three patients with OM and brain tumor were identified; all had undergone tumor resection and targeted brain radiation. All patients complained of unsteadiness while walking or sudden falls. Tumor pathology (atypical meningioma, gliosarcoma, oligodendroglioma) was centered in the frontal lobe and extended to the supplementary motor area (SMA), pre-SMA, or prefrontal cortex in all cases. Medications did not improve gait.

Conclusions: Three cases of brain tumor-related OM suggest that focal disruption of frontal motor programming circuits may be important to the pathophysiology of OM, which is more commonly seen in the setting of neurodegenerative disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/orthostatic-myoclonus-after-brain-tumor-surgery-and-radiation/