Teaching Video NeuroImages: Movement of a paralyzed arm with yawning

A 63-year-old man presented with aphasia and right arm paralysis (Medical Research Council [MRC] grade 0), sparing the leg (video 1 on the Neurology® Web site at Neurology.org). With yawning, his right arm consistently rose to his chest (video 2). Paralysis resumed after yawning. MRI confirmed an acute ischemic stroke in the left middle cerebral artery distribution (figure). This movement ceased after 2 weeks following partial recovery of arm strength (MRC grade 4). This phenomenon, first described in the 1844, was recently coined parakinesia brachialis oscitans. It is speculated to be a release event in which damaged cortical pathways no longer inhibit phylogenetically older brainstem pathways stimulated by yawning.1,2
Source: Neurology - Category: Neurology Authors: Tags: Clinical neurology examination, All Movement Disorders, All Education, Infarction RESIDENT AND FELLOW SECTION Source Type: research