Facial myokymia in syringobulbia
G. Riaz, W. W. Campbell, J. Carr and N. Ghatak
Department of Neurology, St Louis University Medical Center.
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 disinhibition of a
rhythmic neural generator in the facial nucleus.
