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Postby Christian_88 on May 24th, 2010, 3:34 pm

Dear fellow BFSers---

Below is an e-mail i wrote to my neuro....followed by two "medical reports"..on, "Diaphragmatic/Resiratory Myoclonus"-!
Today--for the second time...in 10 days---I was laying on my back in bed....and before falling off...woke up gasping for air!
What i NOTICED was....the "myoclonus"....was in my diaphragm/abdomen...and the strong muscle contractions---(pushing out, while I was inhaling)--was compromising...and interfering with my natural respiration-!

I finally (and satisfactory to me)--read , that I was NOT alone in this...terrible, scary feeling! I had done a search on "Myoclonus of Diaphragm"....when I came across....the two cases--following my e-mail--

Again, now...I no longer worry about my muscle myoclonus/fasics....in my arms..legs....toes...feet, hands---THIS thing...is practically "suffocating"..me! Scary as hell-! Again..I've never seen this...on this forum.....and had to search for it!
THIS.."thing"..is driving me crazy!---OK....below---the e-mail --followed by the two cases of "diaphragmatic/Respiratory myoclonus"-

Hi Dr----

Remember about 2 weeks ago -i saw you outside & was telling you of how my myoclonus--had now gone into my diahpragm...(esp. when lying on my back)--and...when I was dosing off--during the afternoon---i was startled awake 3 or 4 times...feeling "out of air"-?

Dr--i had to find out about this ! (You would not know--unless I told you)---I did a search..& thank God---I found..I am not alone! It does 'exist'-! The strong myoclonic muscle movements in my diaphragm...compromise my "normal'...respiration-!

Dr---just wanted you to see this...& be aware of this---so you know it--before I come in...tomorrow! It does not happen...while on my stomach--just my back! It only occurs..(of course)---when this darn myoclonus....."settles"...for awhile..in the diaphragm! And it seems...so deep--! Almost like you'd need an emg to detect it!

Just sent these 2 medical article for your perusal...and knowledge! I have to let you know...what I'm experiencing! I did not look up something....i did not FIRST FEEL!
*Have you ever seen this in your practice?

Thanks---see you tomorrow---C
--------------------------------------------------------------- FIRST ARTICLE_
Electrophysiological study of diaphragmatic myoclonus.
R Chen, H Remtulla, and C F Bolton
Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada.
This article has been cited by other articles in PMC.
This is the first reported detailed electrophysiological study of diaphragmatic myoclonus. An 86 year old woman had rapid, intermittent epigastric pulsations. Neurological examination and imaging studies of the brain and spinal cord were normal. Needle EMG showed rhythmic contractions of the diaphragm and external intercostal muscles at 4 to 5 Hz. These contractions were often associated with suppression of normal breathing and were capable of maintaining adequate ventilation. Both diaphragms were involved but showed considerable variability in their relative latencies. Automated interference pattern analysis suggested a change in recruitment order, with selective activation of large phrenic motoneurons. The supraspinal mechanisms mediating diaphragmatic myoclonus are different from that of voluntary and involuntary rhythmic breathing, and seem to be unrelated to palatal myoclonus. The generator source is likely related to respiratory centres in the rostral medulla.

------------------------------------------------------------------SECOND ARTICLE BELOW

Isolated diaphragmatic tremor: is there a spectrum in "respiratory myoclonus"?
Espay AJ, Fox SH, Marras C, Lang AE, Chen R.

Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

BACKGROUND: Respiratory myoclonus or diaphragmatic flutter is an unusual movement disorder with abnormal diaphragmatic activity, which may be associated with respiratory symptoms. The effects of distracting maneuvers on diaphragmatic activity have not been investigated. METHODS: Two patients with nondisabling abdominal movements of suspected diaphragmatic origin were studied with surface and needle electromyography (EMG). RESULTS: The abdominal movements resulted from isolated, rhythmic diaphragmatic contractions with variable EMG burst duration, suppressibility with breath-holding and distracting maneuvers, and other attributes of volitional control. CONCLUSION: "Respiratory myoclonus" may be a heterogeneous disorder ranging from synchronous movements of the diaphragm and other respiratory muscles associated with respiratory compromise, to diaphragmatic movements under at least some volitional control with no respiratory or functional disability. The latter group could be designated phenomenologically as "isolated diaphragmatic tremor."
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