Objective: To report the case of a patient with a medial cerebral artery acute stroke who developed parakinesia brachialis oscitans after thrombolysis.

Background: Although rare,  parakinesia brachialis oscitans may occur in the acute phase of MCA stroke patients, even after thrombolysis.

Method: Case report.

Results: A 65-year-old right-handed smoker woman presented with acute onset dysarthria, left-sided weakness and numbness. CT head showed a large stroke in the right MCA distribution and CTA a right M1 segment occlusion (figures 1, 2). She received tPA and developed episodes of yawning and involuntary left elbow and wrist flexion in association with subtle shoulder abduction (video). In MCA strokes, the circuit of yawning become excitable, leading to repetitive yawning. A possible explanation is the impairment of neocortical areas and internal capsule, which affects inhibitory pathways and leads to liberation of subcortical structures responsible for yawning.

Conclusion: In MCA strokes, the circuit of yawning becomes excitable, leading to repetitive yawning and concomitant, synergic movements of the plegic upper limb.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/parakinesia-brachialis-oscitans-due-to-an-acute-medial-cerebral-artery-stroke/