Yuichiro Inatomi1, Yukiko Suzuki2, Makoto Nakajima3, Toshiro Yonehara4. 1. Department of Neurology, Saiseikai Kumamoto Hospital, Chikami 5-3-1, Minami-ku, Kumamoto, 861-4193, Japan. y.inatomix@silk.ocn.ne.jp. 2. Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan. 3. Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 4. Department of Neurology, Saiseikai Kumamoto Hospital, Chikami 5-3-1, Minami-ku, Kumamoto, 861-4193, Japan.
Abstract
OBJECTIVE: Tremor-like movements in patients with the grasp phenomenon are reported rarely. METHODS: We clinically and neuroradiologically studied four patients with tremor-like movements related to the grasp phenomenon. RESULTS: All of the patients were women aged between 61 and 98 years. In the present cases, tremor-like movements were observed in the right arm and/or leg. The movements occurred suddenly in three of the patients and chronically in one. The movements were stereotypic, often rhythmical, tremor-like, and accompanied with groping or picking-like movements. All of the patients displayed the grasp phenomenon, including grasp reflex and/or instinctive grasping reaction ipsilateral to the movements. Two patients had a recent broad infarct ipsilateral to the movements. One patient had meningioma contralateral to the movements, which had been surgically resected. The other patient did not have any radiologically proven cerebral lesions, although she had a history of focal seizures contralateral to the movements. CONCLUSIONS: It was suggested that their abnormal movements were closely related to the grasp phenomenon. We concluded that their characteristic tremor-like movements, a "tremor-like grasp phenomenon," was a variation of the grasp phenomenon that was due to hyperexcitation of the frontal lobe contralateral to the movements.
OBJECTIVE: Tremor-like movements in patients with the grasp phenomenon are reported rarely. METHODS: We clinically and neuroradiologically studied four patients with tremor-like movements related to the grasp phenomenon. RESULTS: All of the patients were women aged between 61 and 98 years. In the present cases, tremor-like movements were observed in the right arm and/or leg. The movements occurred suddenly in three of the patients and chronically in one. The movements were stereotypic, often rhythmical, tremor-like, and accompanied with groping or picking-like movements. All of the patients displayed the grasp phenomenon, including grasp reflex and/or instinctive grasping reaction ipsilateral to the movements. Two patients had a recent broad infarct ipsilateral to the movements. One patient had meningioma contralateral to the movements, which had been surgically resected. The other patient did not have any radiologically proven cerebral lesions, although she had a history of focal seizures contralateral to the movements. CONCLUSIONS: It was suggested that their abnormal movements were closely related to the grasp phenomenon. We concluded that their characteristic tremor-like movements, a "tremor-like grasp phenomenon," was a variation of the grasp phenomenon that was due to hyperexcitation of the frontal lobe contralateral to the movements.
Authors: Eugen Trinka; Hannah Cock; Dale Hesdorffer; Andrea O Rossetti; Ingrid E Scheffer; Shlomo Shinnar; Simon Shorvon; Daniel H Lowenstein Journal: Epilepsia Date: 2015-09-04 Impact factor: 5.864