Propriospinal myoclonus following cervical spinal cord injury: a case report and mechanistic insights

This case report describes a patient who developed propriospinal myoclonus (PSM) after a cervical spinal cord injury (SCI). PSM is characterized by involuntary jerks of the trunk muscles. The patient's PSM was associated with autonomic dysfunction (AD), suggesting a possible link between the two conditions. This link may help explain the variable efficacy of benzodiazepines, a common treatment for PSM. The authors propose that neural plasticity after SCI, involving propriospinal neurons and interneurons, may contribute to both PSM and AD. This suggests a potential target for future treatments.

• 1
  A 38-year-old male developed PSM 48 weeks after a C3 spinal cord injury, characterized by trunk muscle jerks at a frequency of 0.4–0.6 Hz.
• 2
  The patient's PSM was temporally correlated with autonomic dysfunction, specifically a fever of unknown origin, suggesting a shared underlying mechanism.
• 3
  Benzodiazepine treatment (clonazepam) provided some relief of PSM symptoms, but discontinuation led to symptom worsening, highlighting the complexity of managing this condition.