Mirror movement associated with neural tube defects
Yasir Andrabi1, Farideh Nejat1, Mostafa El Khashab2, Mohammad Reza Ashrafi3
1Department of Neurosurgery; 2Department of Neurosurgery, New Jersey, USA;3Department of Pediatric Neurology, Children’s Medical Center, Medical Sciences/University of Tehran, Tehran, Iran
Objective: Association of mirror movements with special kinds of neural tube defects, particularly cranial dermal sinus and cervical myelomeningocele, is extremely rare. We have tried to explain the probable pathophysiology underlying this rare condition.
Clinical presentation: Two cases are presented. Case 1: A right-handed 3-year-old boy brought to the outpatient clinic for evaluation of mirror movement had been operated on at 10 days of age to repair a cervical myelomeningocele. At examination, mirror movements were observed on both sides. Case 2: A right-handed 7-year-old boy referred for vertigo and occasional vomiting since 3 months of age. The mirror movements were present in the upper extremities, and reportedly had existed since early childhood. Brain magnetic resonance imaging disclosed the dermal sinus, tract, and midline dermoid tumor.
Conclusion: To describe a meaningful association between mirror movements and congenital abnormalities in 2 cases reported here, we propose development of an abnormality in the cervical spinal cord (case 1) and cervicomedullary junction (case 2) associated with gross anomalies in the affected areas.
Keywords: cervical myelomeningocele, mirror movement, occipital dermal sinus
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