This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Caudal to the forebrain, the generation of basic locomotion is thought to involve a network of neurons in the brainstem and spinal cord. This network consists of the mesencephalic locomotor region (MLR), reticulospinal neurons in the pontomedullary region, and spinal cord locomotor central pattern generators (CPGs).1 In humans, spinal CPGs are thought to be sufficient for generating stepping movement when activated by appropriate sensory or descending inputs.2 However, the anatomic location of descending pathways connecting brainstem and spinal CPGs that initiate stepping movement has not been defined in humans. Here we describe a remarkable patient who developed transient, bilateral, and uncontrollable stepping movements following unintentional puncture injury at the C2 spinal cord level.
Case report.
A 35-year-old woman with unexplained, unremitting headache underwent a diagnostic cervical spinal tap after an unsuccessful lumbar tap. The cervical tap was complicated by cord puncture, immediately after which the patient developed uncontrollable bilateral stepping movements while supine. The stepping movements involved rhythmic, bilateral hip and knee flexion and extension, and occurred paroxysmally about four to five cycles per minute. Simultaneously the patient described an ill-defined urge to move her legs, but stated that this was not in response to pain or discomfort. Neurologic examination identified …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Alert Me
Recommended articles
Spinal motoneuron excitability after acute spinal cord injury in humans
Metabolites of neuroinflammation relate to neuropathic pain after spinal cord injury
Dorsal and ventral horn atrophy is associated with clinical outcome after spinal cord injury
Trajectory-Based Classification of Recovery in Sensorimotor Complete Traumatic Cervical Spinal Cord Injury