Hyperexcitability restricted to the lower limb motor system in a patient with stiff-leg syndrome

Tomonori Iwata, Hiroshi Shigeto, Katsuya Ogata, Ko Ichi Hagiwara, Yuji Kanamori, Taira Uehara, Yasumasa Ohyagi, Shozo Tobimatsu, Jun Ichi Kira

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We report a 29-year-old man who presented with a 2-year history of progressive stiffness and painful spasms limited to the bilateral lower limbs, exaggerated by auditory and tactile stimuli. His deep tendon reflexes were slightly increased in both lower extremities. His plantar response was flexor. His serum and cerebrospinal fluid were negative for anti-glutamic acid decarboxylase antibodies. Electromyography of antagonist muscle pairs in his distal lower limbs revealed a failure of reciprocal inhibition. We used transcranial magnetic stimulation with a paired-pulse paradigm, delivered to the cortical area of the upper and lower limbs, and revealed significantly enhanced facilitation only in the area of his lower limbs, but not that representing his upper limbs. His symptoms were improved substantially by 20 mg/day of oral diazepam. To our knowledge this is the first report of a patient with hyperexcitability limited to the lower limb motor system in a patient with stiff-leg syndrome.

Original languageEnglish
Pages (from-to)1720-1722
Number of pages3
JournalJournal of Clinical Neuroscience
Volume18
Issue number12
DOIs
Publication statusPublished - Dec 1 2011

Fingerprint

Lower Extremity
Leg
Stretch Reflex
Glutamate Decarboxylase
Transcranial Magnetic Stimulation
Touch
Spasm
Electromyography
Diazepam
Upper Extremity
Cerebrospinal Fluid
Muscles
Antibodies
Serum

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Hyperexcitability restricted to the lower limb motor system in a patient with stiff-leg syndrome. / Iwata, Tomonori; Shigeto, Hiroshi; Ogata, Katsuya; Hagiwara, Ko Ichi; Kanamori, Yuji; Uehara, Taira; Ohyagi, Yasumasa; Tobimatsu, Shozo; Kira, Jun Ichi.

In: Journal of Clinical Neuroscience, Vol. 18, No. 12, 01.12.2011, p. 1720-1722.

Research output: Contribution to journalArticle

Iwata, Tomonori ; Shigeto, Hiroshi ; Ogata, Katsuya ; Hagiwara, Ko Ichi ; Kanamori, Yuji ; Uehara, Taira ; Ohyagi, Yasumasa ; Tobimatsu, Shozo ; Kira, Jun Ichi. / Hyperexcitability restricted to the lower limb motor system in a patient with stiff-leg syndrome. In: Journal of Clinical Neuroscience. 2011 ; Vol. 18, No. 12. pp. 1720-1722.
@article{f876a8b12c4a49efb8a0e7e1fa45419a,
title = "Hyperexcitability restricted to the lower limb motor system in a patient with stiff-leg syndrome",
abstract = "We report a 29-year-old man who presented with a 2-year history of progressive stiffness and painful spasms limited to the bilateral lower limbs, exaggerated by auditory and tactile stimuli. His deep tendon reflexes were slightly increased in both lower extremities. His plantar response was flexor. His serum and cerebrospinal fluid were negative for anti-glutamic acid decarboxylase antibodies. Electromyography of antagonist muscle pairs in his distal lower limbs revealed a failure of reciprocal inhibition. We used transcranial magnetic stimulation with a paired-pulse paradigm, delivered to the cortical area of the upper and lower limbs, and revealed significantly enhanced facilitation only in the area of his lower limbs, but not that representing his upper limbs. His symptoms were improved substantially by 20 mg/day of oral diazepam. To our knowledge this is the first report of a patient with hyperexcitability limited to the lower limb motor system in a patient with stiff-leg syndrome.",
author = "Tomonori Iwata and Hiroshi Shigeto and Katsuya Ogata and Hagiwara, {Ko Ichi} and Yuji Kanamori and Taira Uehara and Yasumasa Ohyagi and Shozo Tobimatsu and Kira, {Jun Ichi}",
year = "2011",
month = "12",
day = "1",
doi = "10.1016/j.jocn.2011.03.021",
language = "English",
volume = "18",
pages = "1720--1722",
journal = "Journal of Clinical Neuroscience",
issn = "0967-5868",
publisher = "Churchill Livingstone",
number = "12",

}

TY - JOUR

T1 - Hyperexcitability restricted to the lower limb motor system in a patient with stiff-leg syndrome

AU - Iwata, Tomonori

AU - Shigeto, Hiroshi

AU - Ogata, Katsuya

AU - Hagiwara, Ko Ichi

AU - Kanamori, Yuji

AU - Uehara, Taira

AU - Ohyagi, Yasumasa

AU - Tobimatsu, Shozo

AU - Kira, Jun Ichi

PY - 2011/12/1

Y1 - 2011/12/1

N2 - We report a 29-year-old man who presented with a 2-year history of progressive stiffness and painful spasms limited to the bilateral lower limbs, exaggerated by auditory and tactile stimuli. His deep tendon reflexes were slightly increased in both lower extremities. His plantar response was flexor. His serum and cerebrospinal fluid were negative for anti-glutamic acid decarboxylase antibodies. Electromyography of antagonist muscle pairs in his distal lower limbs revealed a failure of reciprocal inhibition. We used transcranial magnetic stimulation with a paired-pulse paradigm, delivered to the cortical area of the upper and lower limbs, and revealed significantly enhanced facilitation only in the area of his lower limbs, but not that representing his upper limbs. His symptoms were improved substantially by 20 mg/day of oral diazepam. To our knowledge this is the first report of a patient with hyperexcitability limited to the lower limb motor system in a patient with stiff-leg syndrome.

AB - We report a 29-year-old man who presented with a 2-year history of progressive stiffness and painful spasms limited to the bilateral lower limbs, exaggerated by auditory and tactile stimuli. His deep tendon reflexes were slightly increased in both lower extremities. His plantar response was flexor. His serum and cerebrospinal fluid were negative for anti-glutamic acid decarboxylase antibodies. Electromyography of antagonist muscle pairs in his distal lower limbs revealed a failure of reciprocal inhibition. We used transcranial magnetic stimulation with a paired-pulse paradigm, delivered to the cortical area of the upper and lower limbs, and revealed significantly enhanced facilitation only in the area of his lower limbs, but not that representing his upper limbs. His symptoms were improved substantially by 20 mg/day of oral diazepam. To our knowledge this is the first report of a patient with hyperexcitability limited to the lower limb motor system in a patient with stiff-leg syndrome.

UR - http://www.scopus.com/inward/record.url?scp=82155195844&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=82155195844&partnerID=8YFLogxK

U2 - 10.1016/j.jocn.2011.03.021

DO - 10.1016/j.jocn.2011.03.021

M3 - Article

C2 - 22015096

AN - SCOPUS:82155195844

VL - 18

SP - 1720

EP - 1722

JO - Journal of Clinical Neuroscience

JF - Journal of Clinical Neuroscience

SN - 0967-5868

IS - 12

ER -