Acta Neurologica Belgica

, Volume 113, Issue 3, pp 327–329 | Cite as

Masticatory myorhythmia following pontine hemorrhage

  • Evelien Vancaester
  • Dimitri Hemelsoet
  • Miet De Letter
  • Patrick SantensEmail author
Letter to the Editor


Myorhythmia is an involuntary regular, rhythmic movement, with a frequency of 1–3 Hz. In its most common form, it occurs in ocular and masticatory muscles (oculomasticatory myorhythmia, OMM), all or not in combination with skeletal muscles (oculofacial-skeletal myorhythmia, OFSM). When different body parts are involved, movements can either be synchronous or not. Masucci et al. [1] found clinicopathological correlates of limb myorhythmias in autopsy series, with involvement of the dentate nucleus, superior cerebellar peduncle, substantia nigra or inferior olive.

OMM or OFSM is most often associated with Whipple’s disease (WD) [2, 3, 4]. Neurologic manifestations emerge in 10–40 percent of patients with WD [5, 6]. OMM and OFSM occur in 8 percent of patients and are pathognomonic for this condition. Ocular myorhythmia consists mostly of convergent–divergent nystagmus, frequently in conjunction with supranuclear gaze palsy [6].

Other, less frequent disorders in which OMM or...


Inferior Olive Masticatory Muscle Sick Sinus Syndrome Superior Cerebellar Peduncle Brainstem Auditory Evoke Response 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest


Supplementary material

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  1. 1.
    Masucci EF, Kurtzke JF, Saini N (1984) Myorhythmia: a widespread movement disorder. Clinicopathological correlations. Brain 107:53–79PubMedCrossRefGoogle Scholar
  2. 2.
    Revilla FJ, de la Cruz R, Khardori N, Espay AJ (2008) Teaching neuroimage: Oculomasticatory myorhythmia: Pathognomonic phenomenology of Whipple disease. Neurology 70:e25PubMedCrossRefGoogle Scholar
  3. 3.
    Ciampi de Andreade D, Noqueira RC, Lucato LT, Marchiori PE, Machado LR, Teixeira MJ, Scaff M (2007) Isolated CNS Whipple disease with a variant of oculofacial-skeletal myorhythmia (OFSM). Neurology 69:E12CrossRefGoogle Scholar
  4. 4.
    Simpson DA, Wishnow R, Gargulinski RB, Pawlak AM (1995) Oculofacial-skeletal myorhythmia in central nervous system Whipple’s disease: additional case and review of the literature. Mov Disord 10:195–200PubMedCrossRefGoogle Scholar
  5. 5.
    Louis ED, Lynch T, Kaufmann P, Fahn S, Odel J (1996) Diagnostic guidelines in central nervous system Whipple’s disease. Ann Neurol 40:561–568PubMedCrossRefGoogle Scholar
  6. 6.
    Schneider T, Moos V, Loddenkemper C, Marth T, Fenollar F, Raoult D (2008) Whipple’s disease: new aspects of pathogenesis and treatment. Lancet Infect Dis 8:179–190PubMedCrossRefGoogle Scholar
  7. 7.
    Hirono N, Kameyama M, Kobayashi Y, Udaka F, Mezaki T, Abe K, Nishitani N (1990) MR demonstration of a unilateral olivary hypertrophy caused by pontine tegmental hematoma. Neuroradiology 32:340–342PubMedCrossRefGoogle Scholar
  8. 8.
    Lera G, Scipioni O, Garcia S, Cammarota A, Fischbein G, Gershanik O (2000) A combined pattern of movement disorders resulting from posterolateral thalamic lesions of a vascular nature: a syndrome with clinico-radiologic correlation. Mov Disord 15:120–126PubMedCrossRefGoogle Scholar
  9. 9.
    Wiener V, Honnorat J, Pandolfo M, Kentos A, Manto J (2003) Myorhythmia associated with Hodgkin’s lymphoma. J Neurol 250:1382–1384PubMedCrossRefGoogle Scholar
  10. 10.
    Erickson JC, Carrasco H, Grimes JB, Jabbari B, Cannard KR (2002) Palatal tremor and myorhythmia in Hashimoto’s encephalopathy. Neurology 58:504–505PubMedCrossRefGoogle Scholar
  11. 11.
    Park KI, Chung JM, Lee SH, Lee HK (2010) Myorhythmia associated with listerial rhombencephalitis. Mov Disord 25:950–952PubMedCrossRefGoogle Scholar
  12. 12.
    Dimberg EL, Crowe SE, Trugman JM, Swerdlow RH, Lopes MB, Bourne TD, Burns TM (2007) Fatal encephalitis in a patient with refractory celiac disease presenting with myorhythmia and carpal spasm. Mov Disord 22:407–411PubMedCrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2013

Authors and Affiliations

  • Evelien Vancaester
    • 1
  • Dimitri Hemelsoet
    • 1
  • Miet De Letter
    • 2
  • Patrick Santens
    • 1
    Email author
  1. 1.Department of NeurologyGhent University HospitalGhentBelgium
  2. 2.Department of Logopaedic/Audiologic SciencesGhent UniversityGhentBelgium

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