Journal of Neurology

, Volume 265, Issue 2, pp 433–435 | Cite as

Voluntary control of a plegic limb during yawning

  • Pedro Nascimento AlvesEmail author
  • Mamede de Carvalho
  • Sofia Reimão
  • José Castro
  • Ana Catarina Fonseca
  • Patrícia Canhão
Letter to the Editors

Dear Sirs,

Yawning is a phylogenetically ancient phenomenon coordinated by a network of supratentorial and infratentorial centres located in brainstem, hypothalamus, and limbic regions [1]. Movements of plegic limbs during yawning in patients with stroke are common [2]. The first descriptions come from the 18th and 19th centuries by Darwin and by Abercrombie, respectively [3, 4]. These movements have always been described as involuntary and stereotyped, however [5].

We report a novel phenomenon: a stroke patient who could voluntarily control the movements of his plegic limb during yawning.

A 59-year-old right-handed male was admitted in the emergency department presenting right facial palsy, dysarthria, right hemiplegia, and right pain anesthesia of sudden onset. The relevant medical antecedents were diabetes mellitus and arterial hypertension. The presentation suggested a sensorimotor lacunar syndrome due to a subcortical stroke. The diagnosis of acute left Middle Cerebral Artery...


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standard

The authors declare that they complied with ethical standards and the study was in accord with the Helsinki Declaration. The patient has given his informed consent to this anonymous case report.

Supplementary material

Online Resource 1 Video showing the ability of the patient to follow the instructions of the observer with his right plegic superior limb while yawning. More sustained periods of yawning with more complex movements were described by the patient, but were not caught in the recording, due to the infrequency of yawning (MOV 6907 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosciences and Mental Health, Neurology, Stroke UnitHospital de Santa Maria, CHLNLisbonPortugal
  2. 2.Language Research LaboratoryUniversity of LisbonLisbonPortugal
  3. 3.Department of Neurosciences and Mental Health, Neurology, EMG LabHospital de Santa Maria, CHLNLisbonPortugal
  4. 4.Faculty of MedicineUniversity of LisbonLisbonPortugal
  5. 5.Department of NeuroradiologyHospital de Santa Maria, CHLNLisbonPortugal

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