Objective: Analysis of clinical course of oculopalatal myoclonus (OPM) and MRI images of the brain.

Background: OPM are rare movement disorders connected with the injury in Guillain-Mollaret triangle, especially with hypertrophy of inferior olivary nucleus. The imbalance between inferior olivary nucleus and cerebellum activity is the most crucial in pathophysiology of OPM.

Methods: Patients who developed the OPM in the several months’ time after brain injury and who were hospitalized in the Neurorehabilitation Ward of Institute of Psychiatry and Neurology in Warsaw in 2012-2014 were analyzed. The etiology, clinical status, the area of injury in the brain, the functional status and the response to the treatment were taken into account.

Results: There were 4 patients who developed the OPM (0,84% of all hospitalized stroke patients). In three cases, the brain injury were caused by ischemic stroke in posterior circulation area, whereas the fourth case was caused by bleeding from ruptured arteriovenous malformations in brainstem and resection of the malformations. In all the cases, myoclonus of the face, the tongue, the pharynx and/or the diaphragm beside the OPM were developed. In all the cases the MRI images revealed lesions in the region of Guillain-Mollaret triangle. Neurological and functional status of the patients was severe (mRS = 4). Unsatisfactory improvement after applied pharmacological therapy such as valproic acid, levetiracetam, botulinum toxin in all the cases was achieved.

Conclusions: The OPM are rare, treatment-resistant movement disorders, most often connected with vascular injury of the brain.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/oculopalatal-myoclonus-after-stroke/