Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2020; 8(2): 313-317
Published online Jan 26, 2020. doi: 10.12998/wjcc.v8.i2.313
Role of a wireless surface electromyography in dystonic gait in functional movement disorders: A case report
Min-Kyun Oh, Hyeong Seop Kim, Yun Jeong Jang, Chang Han Lee
Min-Kyun Oh, Hyeong Seop Kim, Yun Jeong Jang, Chang Han Lee, Department of Rehabilitation Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, Gyeongsangnam-do, South Korea
Author contributions: Lee CH and Oh MK contributed equally to this work; Lee CH and Oh MK designed research, performed research, contributed new reagents/analytic tools, analyzed data and wrote the paper; Kim HS and Jang YJ revised the paper.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chang Han Lee, MD, Assistant Professor, Department of Rehabilitation Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 90 Chilamdong, Jinju 52727, Gyeongsangnam-do, South Korea. ychkhk1407@gmail.com
Received: September 26, 2019
Peer-review started: September 26, 2019
First decision: October 24, 2019
Revised: December 25, 2019
Accepted: January 1, 2020
Article in press: January 1, 2020
Published online: January 26, 2020
Processing time: 112 Days and 11.1 Hours
Abstract
BACKGROUND

Dystonic gait (DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders (FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.

CASE SUMMARY

A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography (EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius (GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.

CONCLUSION

We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.

Keywords: Gait disorders; Dystonic gait; Surface electromyography; Functional movement disorders; Case report

Core tip: Dystonic gait occur as one of clinical symptoms associated with functional dystonia in the functional movement disorders. Dystonia is often initiated by voluntary action and associated with persistent muscle activation. In the functional movement disorders, mere presence of an abnormal gait does not confirm a functional etiology. We report an importance of a wireless surface electromyography when it comes to diagnosis the dystonic gait in functional movement disorders, in which other examination didn’t reveal the cause of dystonic gait.