A Case Report of Abdominal Myoclonus Following Anterior Cerebral Artery Stroke
Ksenia Nokhrina1, Guillaume Lamotte1, Jana Wold1
1Neurology Department, University of Utah Health
Objective:
This case highlights cortical abdominal myoclonus as a rare presentation of anterior cerebral artery (ACA) stroke, emphasizing the importance of early recognition for timely treatment.
Background:
Post-stroke movement disorders are rare, with myoclonus being a particularly uncommon manifestation. Notably, abdominal myoclonus following ACA infarction has not been reported.
Design/Methods:
We present a case report of post-stroke myoclonus limited to the abdominal muscles following ACA infarction.
Results:
A 75-year-old man presented with acute right-sided weakness and involuntary, rhythmic contractions of the abdominal muscles, predominantly on the right side. Brain magnetic resonance imaging (MRI) revealed an acute left ACA infarction involving the precentral gyrus. Scalp electroencephalography (EEG) showed no epileptiform activity. The rhythmic abdominal contractions were attributed to abdominal myoclonus secondary to acute cortical infarction. The abdominal myoclonus resolved quickly after administration of intravenous levetiracetam and did not recur. Levetiracetam was continued for seven days after discharge and then discontinued, with no recurrence of myoclonus.
Conclusions:
Abdominal myoclonus can be a manifestation of acute ischemic stroke involving the frontoparietal regions, where the abdominal wall is represented within the motor and somatosensory homunculus. Epileptiform abnormalities on ictal or interictal EEG may not be present. Prompt treatment with an antiepileptic medication, such as levetiracetam, may improve the outcome.
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