Propriospinal myoclonus: is it always psychogenic?

Propriospinal myoclonus (PSM) is a rare type of movement disorder in which the myoclonic jerks are present or intensified in supine position. Arising from a thoracic or abdominal generator, the movements propagate rostrocaudally as per the spinospinal conduction velocity. Routine neuroimaging and electrophysiology being normal in most instances, it is frequently interpreted as psychogenic. We present a case of PSM which will throw ample light on the pathophysiology, approach and dilemmas in treatment.