Objective: clonic twitching of the rectus abdominis muscle and tonic spasm of the diaphragm

Background: 61-year-old patient seeking medical help for difficulties lasting about a month in terms of respiratory muscle contractions with dyspnoe

and epigastric pain.

Method: MRI scans of the brain showed subacute bleeding of cavernoma in the Guillain-Mollaret (myoclonic) triangle. Guillain-Mollaret triangle is an important feedback circuit of the brainstem and deep cerebellar nuclei which is responsible for modulating spinal cord motor activity.

Results: diaphragmatic myoclonus was successfully treated by injecting botulinum toxin A  under needle electromyography (EMG) guidance.

Conclusion: Diaphragmatic flutter (myoclonus) is a rare condition  characterised by high-frequency, involuntary contractions of the diaphragmatic muscles. It is often accompanied by contractions of accessory respiratory muscles and is then known as respiratory myoclonus.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diaphragmatic-flutter-when-the-diaphragm-does-not-obey/