Spinal cord seizures: a possible cause of isolated myoclonic activity in traumatic spinal cord injury

Spinal cord seizures: a possible cause of isolated myoclonic activity in traumatic spinal cord injury

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ABSTRACT Spinal cord seizures are infrequently reported. They have been associated with intravenous dye placement, transverse myelitis and multiple sclerosis, but never with traumatic spinal cord injury (SCI). We report the case of a 48-year-old SCI male with complete C6 quadriplegia, and apparent spinal cord seizures. These seizures were characterised by myoclonus simplex activity involving the upper extremities only. The lower extremities were spared. The patient was conscious throughout the myoclonic activity and an electroencephalogram of the brain obtained during an event revealed no cortical epiliptiform activity. The seizures lasted approximately 30 seconds to a few minutes, and an acute increase in blood pressure and a decrease in pulse generally occurred 30 to 60 seconds prior to the event. Previously reported spinal cord seizures in multiple sclerosis were frequently treated with carbamazepine. In this case successful treatment was with diazepam. Spinal cord seizures may present in those with traumatic SCI. Benzodiaze-pines may be useful in the treatment of spinal cord seizures. SIMILAR CONTENT BEING VIEWED BY OTHERS IDIOPATHIC CERVICAL CORD INFARCTION IN A YOUNG GIRL PRESENTING WITH ACUTE NECK PAIN AND FLACCID PARALYSIS: A CASE REPORT Article 03 August 2024 ACUTE ON CHRONIC CERVICAL MYELOPATHY CAUSING CERVICAL SEGMENTAL MYOCLONUS IN A HIGH-LEVEL WHEELCHAIR ATHLETE: A CASE REPORT Article 29 September 2021 NON-TRAUMATIC SPINAL CORD INFARCTION OF THE CONUS MEDULLARIS IN A CHILD: A CASE REPORT Article 15 July 2021 ARTICLE PDF REFERENCES * Broughton A, Burr R G 1972 Magnesium metabolism following spinal cord injury. _Paraplegia_ 10: 134–141. CAS  PubMed  Google Scholar  * Browne T R, Penry J K 1973 Benzodiazepines in the treatment of epilepsy: A review. _Epilepsia_ 14: 277–310. Article  CAS  PubMed  Google Scholar  * Castaigne P, Cambier J, Branet P 1968 Spinal sensory-motor seizures. _Lancet_ I: 357. Article  Google Scholar  * Cherrick A A, Ellenberg M 1986 Spinal cord seizures in transverse myelopathy: Report of two cases. _Archives of Physical Medicine and Rehabilitation_ 67: 129–131. Article  CAS  PubMed  Google Scholar  * Ekbom K A, Westerberg C E, Osterman P O 1968 Focal sensory-motor seizures of spinal origin. _Lancet_ I: 67. Article  Google Scholar  * Erickson R P 1980 Autonomic hyperreflexia: Pathophysiology and medical management. _A rchives of Physical Medicine and Rehabilitation_ 61: 431–440. CAS  Google Scholar  * Espir M L, Millac P 1970 Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine. _Journal Neurology Neurosurgery Psychiatr_ 33: 528–531. Article  CAS  Google Scholar  * Glaser G H 1982 Cecil's Textbook of Medicine, WB Saunders Co., Philadelphia, pp 2114-2124. * Frankel H L, Hancock D O, Hyslop G, et al., 1969 The value of postural reduction in the initial management of closed in juries of the spinal with paraplegia and tetraplegia. _Paraplegia_ 7: 179–182. CAS  PubMed  Google Scholar  * Matthews W B 1975 Paroxysmal symptoms in multiple _sclerosis. Journal Nenrol Neurosurg Psychiatry_ 38: 617–623. Article  CAS  Google Scholar  * Tokokura Y, Sakuta M, Nakanishi T 1976 Painful tonic seizures in multiple sclerosis. _Neurology_ 26/2: 18–19. Article  Google Scholar  * Twomey J A, Espir M L E 1980 Paroxysmal symptoms as the manifestations of multiple sclerosis. _Journal Neurology Neurosurgery and Psychiatry_ 43: 296–304. Article  CAS  Google Scholar  * Uhl G R, Martinez C R, Brooks B R 1981 Spinal seizures following intravenous contrast in a patient with a cord AVM. _Annales of Neurology_ 231: 225–230. Google Scholar  * Watson C P, Chiu M 1979 Painful tonic seizures in multiple sclerosis: Localization of a lesion. _Canadian Journal Neurological Sciences_ 6: 359–361. Article  CAS  Google Scholar  * Yarkony G M, Katz R T Yeong-Chi W 1986 Seizures secondary to autonomic dysreflexia. _Archives of Physical Medicine and Rehabilitation_ 67: 834–835. CAS  PubMed  Google Scholar  * Young R R, Delwaide P J 1981 Drug therapy: Spasticity. _New England Journal Medicine_ 304: 96–99. Article  CAS  Google Scholar  * Yu J, Chambers W W, Liu C N 1984 Introduction of spinal seizures by natural stimulation in cats. _Brain Research_ 299: 323–330. Article  CAS  PubMed  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Virginia Spinal Cord Injury System, University of Virginia Health Sciences Center, Charlottesville, 22908, Virginia, USA J M Meythaler, S M Tuel & L L Cross Authors * J M Meythaler View author publications You can also search for this author inPubMed Google Scholar * S M Tuel View author publications You can also search for this author inPubMed Google Scholar * L L Cross View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Meythaler, J., Tuel, S. & Cross, L. Spinal cord seizures: a possible cause of isolated myoclonic activity in traumatic spinal cord injury. _Spinal Cord_ 29, 557–560 (1991). https://doi.org/10.1038/sc.1991.81 Download citation * Issue Date: 01 October 1991 * DOI: https://doi.org/10.1038/sc.1991.81 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * Spinal cord injury * Seizures * Myoclonus * Benzodiazepines * Autonomic dysreflexia * Spasticity

ABSTRACT Spinal cord seizures are infrequently reported. They have been associated with intravenous dye placement, transverse myelitis and multiple sclerosis, but never with traumatic spinal


cord injury (SCI). We report the case of a 48-year-old SCI male with complete C6 quadriplegia, and apparent spinal cord seizures. These seizures were characterised by myoclonus simplex


activity involving the upper extremities only. The lower extremities were spared. The patient was conscious throughout the myoclonic activity and an electroencephalogram of the brain


obtained during an event revealed no cortical epiliptiform activity. The seizures lasted approximately 30 seconds to a few minutes, and an acute increase in blood pressure and a decrease in


pulse generally occurred 30 to 60 seconds prior to the event. Previously reported spinal cord seizures in multiple sclerosis were frequently treated with carbamazepine. In this case


successful treatment was with diazepam. Spinal cord seizures may present in those with traumatic SCI. Benzodiaze-pines may be useful in the treatment of spinal cord seizures. SIMILAR CONTENT


BEING VIEWED BY OTHERS IDIOPATHIC CERVICAL CORD INFARCTION IN A YOUNG GIRL PRESENTING WITH ACUTE NECK PAIN AND FLACCID PARALYSIS: A CASE REPORT Article 03 August 2024 ACUTE ON CHRONIC


CERVICAL MYELOPATHY CAUSING CERVICAL SEGMENTAL MYOCLONUS IN A HIGH-LEVEL WHEELCHAIR ATHLETE: A CASE REPORT Article 29 September 2021 NON-TRAUMATIC SPINAL CORD INFARCTION OF THE CONUS


MEDULLARIS IN A CHILD: A CASE REPORT Article 15 July 2021 ARTICLE PDF REFERENCES * Broughton A, Burr R G 1972 Magnesium metabolism following spinal cord injury. _Paraplegia_ 10: 134–141. CAS


  PubMed  Google Scholar  * Browne T R, Penry J K 1973 Benzodiazepines in the treatment of epilepsy: A review. _Epilepsia_ 14: 277–310. Article  CAS  PubMed  Google Scholar  * Castaigne P,


Cambier J, Branet P 1968 Spinal sensory-motor seizures. _Lancet_ I: 357. Article  Google Scholar  * Cherrick A A, Ellenberg M 1986 Spinal cord seizures in transverse myelopathy: Report of


two cases. _Archives of Physical Medicine and Rehabilitation_ 67: 129–131. Article  CAS  PubMed  Google Scholar  * Ekbom K A, Westerberg C E, Osterman P O 1968 Focal sensory-motor seizures


of spinal origin. _Lancet_ I: 67. Article  Google Scholar  * Erickson R P 1980 Autonomic hyperreflexia: Pathophysiology and medical management. _A rchives of Physical Medicine and


Rehabilitation_ 61: 431–440. CAS  Google Scholar  * Espir M L, Millac P 1970 Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine. _Journal Neurology Neurosurgery


Psychiatr_ 33: 528–531. Article  CAS  Google Scholar  * Glaser G H 1982 Cecil's Textbook of Medicine, WB Saunders Co., Philadelphia, pp 2114-2124. * Frankel H L, Hancock D O, Hyslop G,


et al., 1969 The value of postural reduction in the initial management of closed in juries of the spinal with paraplegia and tetraplegia. _Paraplegia_ 7: 179–182. CAS  PubMed  Google Scholar


  * Matthews W B 1975 Paroxysmal symptoms in multiple _sclerosis. Journal Nenrol Neurosurg Psychiatry_ 38: 617–623. Article  CAS  Google Scholar  * Tokokura Y, Sakuta M, Nakanishi T 1976


Painful tonic seizures in multiple sclerosis. _Neurology_ 26/2: 18–19. Article  Google Scholar  * Twomey J A, Espir M L E 1980 Paroxysmal symptoms as the manifestations of multiple


sclerosis. _Journal Neurology Neurosurgery and Psychiatry_ 43: 296–304. Article  CAS  Google Scholar  * Uhl G R, Martinez C R, Brooks B R 1981 Spinal seizures following intravenous contrast


in a patient with a cord AVM. _Annales of Neurology_ 231: 225–230. Google Scholar  * Watson C P, Chiu M 1979 Painful tonic seizures in multiple sclerosis: Localization of a lesion. _Canadian


Journal Neurological Sciences_ 6: 359–361. Article  CAS  Google Scholar  * Yarkony G M, Katz R T Yeong-Chi W 1986 Seizures secondary to autonomic dysreflexia. _Archives of Physical Medicine


and Rehabilitation_ 67: 834–835. CAS  PubMed  Google Scholar  * Young R R, Delwaide P J 1981 Drug therapy: Spasticity. _New England Journal Medicine_ 304: 96–99. Article  CAS  Google


Scholar  * Yu J, Chambers W W, Liu C N 1984 Introduction of spinal seizures by natural stimulation in cats. _Brain Research_ 299: 323–330. Article  CAS  PubMed  Google Scholar  Download


references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Virginia Spinal Cord Injury System, University of Virginia Health Sciences Center, Charlottesville, 22908, Virginia, USA J M


Meythaler, S M Tuel & L L Cross Authors * J M Meythaler View author publications You can also search for this author inPubMed Google Scholar * S M Tuel View author publications You can


also search for this author inPubMed Google Scholar * L L Cross View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and


permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Meythaler, J., Tuel, S. & Cross, L. Spinal cord seizures: a possible cause of isolated myoclonic activity in traumatic spinal cord


injury. _Spinal Cord_ 29, 557–560 (1991). https://doi.org/10.1038/sc.1991.81 Download citation * Issue Date: 01 October 1991 * DOI: https://doi.org/10.1038/sc.1991.81 SHARE THIS ARTICLE


Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided


by the Springer Nature SharedIt content-sharing initiative KEYWORDS * Spinal cord injury * Seizures * Myoclonus * Benzodiazepines * Autonomic dysreflexia * Spasticity