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Ghazala Riaz, MD; William W. Campbell, MD; Jeri Carr, MD; Nitya Ghatak, MD

Arch Neurol. 1990;47(4):472-474.

Abstract
• A patient with a 2-year history of progressive ataxia and tingling in the right hand had prominent facial myokymia. Magnetic resonance imaging revealed syringomyelia and syringobulbia. After successful syringosubarachnoid shunting, the patient died of massive pulmonary embolism. Postmortem examination revealed a syrinx involving the spinal cord and lower half of the medulla; neither the facial nucleus nor facial nerve fibers were directly involved. We hypothesize that interruption of aberrant corticobulbar fibers in the medulla produced dysinhibition of a rhythmic neural generator in the facial nucleus.

Author Affiliations
From the Department of Neurology, St Louis (Mo) University Medical Center (Dr Riaz), and the Departments of Neurology (Drs Campbell and Carr) and Neuropathology (Dr Ghatak), Medical College of Virginia, Richmond.

Footnotes
Accepted for publication September 29, 1989.

Reprint requests to Neurology (127), McGuire Veterans Administration Medical Center, 1201 Broad Rock Rd, Richmond, VA 23249 (Dr Campbell).

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