Belly Dancer's Dyskinesia!!!
“first described by Antonie van Leeuwenhoek in 1723 when he himself experienced the symptoms”
#MedTwitter #neurotwitter #EndNeurophobia #tweetorials
1/
“first described by Antonie van Leeuwenhoek in 1723 when he himself experienced the symptoms”
#MedTwitter #neurotwitter #EndNeurophobia #tweetorials
1/
Definition
“rhythmic, involuntary contractions of the diaphragm resulting in undulating, rhythmic movements of the abdomen resembling a belly dance”
-bilateral, most freq
-limited to axial musculature
-sometimes painful
-no suppress on breath holding
-150 contraction/min
2/
“rhythmic, involuntary contractions of the diaphragm resulting in undulating, rhythmic movements of the abdomen resembling a belly dance”
-bilateral, most freq
-limited to axial musculature
-sometimes painful
-no suppress on breath holding
-150 contraction/min
2/
History
1723, Leeuwenhoek
- 1st report
- diaphragmatic flutter
1976, Nichols
- 1st report
- abdominal wall dyskinesia
- phrenic palsy in a newborn
1990, Iliceto
≠ diaphragmatic flutter
3/
1723, Leeuwenhoek
- 1st report
- diaphragmatic flutter
1976, Nichols
- 1st report
- abdominal wall dyskinesia
- phrenic palsy in a newborn
1990, Iliceto
≠ diaphragmatic flutter
3/
Pathophysiology
- dysfunction of inhibitory interneurons (spinal interneurons)
- structural reorganization of local neuronal circuit
4/
- dysfunction of inhibitory interneurons (spinal interneurons)
- structural reorganization of local neuronal circuit
4/
Causes
Phrenic nerve injury
Phrenic nerve irritation: pleurisy, peritonitis, cardiomegaly, post-CABG, abdominal surgery
Spinal cord lesions
Central causes: encephalitis, Extrapontine myelinolysis
Drugs: galantamine, clebopride
Functional
Others: Vit B12 def
5/
Phrenic nerve injury
Phrenic nerve irritation: pleurisy, peritonitis, cardiomegaly, post-CABG, abdominal surgery
Spinal cord lesions
Central causes: encephalitis, Extrapontine myelinolysis
Drugs: galantamine, clebopride
Functional
Others: Vit B12 def
5/
Clinical tips!
Phrenic nerve irritation
- heart most common cause
- flutter synchronous w/ systole
Bilateral diaphragmatic flutter
- central origin
Sleep
- continuous contractions in central
- peripheral, subside
Functional
- breath hold test
- only awake
6/
Phrenic nerve irritation
- heart most common cause
- flutter synchronous w/ systole
Bilateral diaphragmatic flutter
- central origin
Sleep
- continuous contractions in central
- peripheral, subside
Functional
- breath hold test
- only awake
6/
Workup
- fluoroscopy
- diaphragmatic EMG
- abdominal imaging
- brain and spinal neuroimaging
7/
- fluoroscopy
- diaphragmatic EMG
- abdominal imaging
- brain and spinal neuroimaging
7/
Management
“some resolve spontaneously while others persist”
- benzodiazepines
- antipsychotics
- phrenic nerve block
8/
“some resolve spontaneously while others persist”
- benzodiazepines
- antipsychotics
- phrenic nerve block
8/
Belly dancer's dyskinesia
💡patient occasionally voluntarily shrugged her shoulders in response to her abdominal discomfort
doi.org/10.1007/978-1-… via: Movement Disorders: A Video Atlas
9/
💡patient occasionally voluntarily shrugged her shoulders in response to her abdominal discomfort
doi.org/10.1007/978-1-… via: Movement Disorders: A Video Atlas
9/
Belly dancer's dyskinesia
via: Seri Jelita
10/
via: Seri Jelita
10/
Belly dancer's dyskinesia
via: ank vaish
13/
via: ank vaish
13/
Belly dancer's dyskinesia
💡domperidone-cause
💡clonazepam & promethazine responsive
doi.org/10.7759/cureus… via: Cureus
14/
💡domperidone-cause
💡clonazepam & promethazine responsive
doi.org/10.7759/cureus… via: Cureus
14/
Belly dancer's dyskinesia
💡levodopa-induced
doi.org/10.1016/j.prdo… via: Clinical Parkinsonism & Related Disorders
15/
💡levodopa-induced
doi.org/10.1016/j.prdo… via: Clinical Parkinsonism & Related Disorders
15/
Belly dancer's dyskinesia
💡levodopa-induced
doi.org/10.1016/j.prdo… via: Clinical Parkinsonism & Related Disorders
16/
💡levodopa-induced
doi.org/10.1016/j.prdo… via: Clinical Parkinsonism & Related Disorders
16/
Belly dancer's dyskinesia
💡dystonia
💡GPi Pallidotomy-responsive
doi.org/10.1016/j.wneu… via: World Neurosurgery
17/
💡dystonia
💡GPi Pallidotomy-responsive
doi.org/10.1016/j.wneu… via: World Neurosurgery
17/
Belly dancer's dyskinesia
💡functional
💡EMG helpful to ≠
doi.org/10.1002%2Fmdc3… via: Mov Disord Clin Pract
18/
💡functional
💡EMG helpful to ≠
doi.org/10.1002%2Fmdc3… via: Mov Disord Clin Pract
18/
Belly dancer's dyskinesia
💡 haloperidol & clobazam-responsive
doi.org/10.1055/s-0042… via: J Neurosci Rural Pract
20/
💡 haloperidol & clobazam-responsive
doi.org/10.1055/s-0042… via: J Neurosci Rural Pract
20/
Belly dancer's dyskinesia
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
21/
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
21/
Belly dancer's dyskinesia
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
22/
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
22/
Belly dancer's dyskinesia
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
23/
💡vit B12 def
💡clonazepam-responsive
doi.org/10.1159/000521… via: Karger
23/
Differ
Abdominal segmental myoclonus resembling belly dancer's dyskinesia
💡EMG
💡CASPR2 antibody
doi.org/10.1002/mdc3.1… via: Mov Disord Clin Pract
25/
Abdominal segmental myoclonus resembling belly dancer's dyskinesia
💡EMG
💡CASPR2 antibody
doi.org/10.1002/mdc3.1… via: Mov Disord Clin Pract
25/
NeuroTeach - Content
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The blog contains all the threads and videos.
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Have a great day!
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