Painful tonic spasm
The video shows a 63 y/o male with transverse myelitis who had a 3 week history of episodic spasms of the left arm and leg that came on acutely, lasted less than a minute, then entirely resolved. They were very painful, and consciousness was entirely normal. The episodes occurred several times a day. Exam showed mild hyperreflexia and an upgoing toe on the left. C-spine MRI showed a T2 hyperintensity at C5-6.(Figure)
Video courtesy of Dr. Jason Hawley of Walter Reed National Military Medical Center
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