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Difficulty Writing in a Patient with Multiple Sclerosis
Manuel Melo-Bicchi1*, Jason Margolesky2 and Corneliu Luca21University of Miami, Department of Neurology, Resident Physician
2University of Miami, Department of Neurology, Movement Disorder Division
- *Corresponding Author:
- Manuel Melo-Bicchi
University of Miami, Department of Neurology
1120 NW 14th Street, Ste. 1383 Miami
FL, 33136, US
Tel: 305 243- 2742
Fax: 305 243-8108
E-mail: [email protected]
Received Date: June 13, 2017 Accepted Date: June 20, 2017 Published Date: June 23, 2017
Citation: Melo-Bicchi M, Margolesky J, Luca C (2017) Difficulty Writing in a Patient with Multiple Sclerosis. J Neurol Disord 5: 351. doi:10.4172/2329- 6895.1000351
Copyright: © 2017 Melo-Bicchi M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Difficulty Writing in a Patient with Multiple Sclerosis
We present a 65-year-old right-handed woman with a two-year history of involuntary right-hand movements while writing (Video 1). She denied history of vision loss, weakness or numbness. MRI of her brain and cervical spine are shown in (Figure 1). CSF analysis was suggestive for multiple sclerosis (MS) with five oligoclonal bands and elevated myelin basic protein. Tremor is a frequent finding in patients with MS. Other movement abnormalities are described in about 1.6% of MS patients [1], including writer’s cramp with cervical cord lesions [2]. The contralateral parietal lesion may play a role in our patient.
Figure 1: MRI brain FLAIR sequences (a and b) with abnormal signal abnormality lesions seen in the left parietal lobe and scattered throughout juxta cortical and subcortical regions. MRI cervical spine (c) T2 sequence at the level C3-C4 showing signal abnormality (arrow) in the left dorsolateral aspect of the spinal cord.
References
- Raja Mehanna, Joseph Jankovic (2013) Movement disorders in multiple sclerosis and other demyelinating diseases. J Neurol Sci 328: 1-8.
- Joong-Seok Kim, Tae-ho Guak, Jae Young Ahn, Yeong-In Kim, Tae-Won Kim, et al. (2007) Writer’s cramp as a manifestation of cervical demyelinating lesions. Eur Neurol 58: 54-56.
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