LAUSR

BACKGROUND Spinal myoclonus (SM) is a rare hyperkinetic movement disorder that is either idiopathic or secondary to spinal cord lesions. The treatment is either merely symptomatic or addresses the underlying etiology. We describe two patients suffering SM with compression myelopathy, who were treated with spinal cord stimulation (SCS). CASES A 39-year-old man with cervicobrachial pain due to compression myelopathy at level C5/6 underwent fusion. A year later, he developed neurological deficits including a left-limb dominant tetraparesis and involuntary movements of the right leg. Despite ventral fusion at C5-C7 due to progressive myelopathy, the involuntary movements extended to both left extremities. A paddle electrode was placed at level C5/6. SM disappeared immediately under stimulation and the effect continued even after 24 months. The second patient, a 57-year-old man, became a fusion at level C5/6 in the year 1998. Since then, there was a persistent tremor in his left hand. After 20 years, he developed cervicobrachial pain of the right upper limb with paresis. A compression myelopathy at segment C6/7 was treated with fusion plating. Six months later, pain returned in both upper limbs and the tremor extended discreetly to his right side. He got a paddle electrode for SCS at level C7/Th1. SM disappeared immediately under stimulation and the effect persisted after 10 months. Both patients reported a sustained pain reduction. CONCLUSION SCS might offer a more selective medicament-free therapy option for SM. The activation of intraspinal networks and replacement of supraspinal descending influences are mechanisms of SCS in this disorder.