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• Myoclonic contractions of muscles in the abdominal wall and lower extremities developed in a 47-year-old paraplegic woman. The spinal cord was compressed from T-3 to T-8 by an extradural renal cell carcinoma metastasis. To our knowledge, previous studies of patients with spinal myoclonus have not reported a pathologic correlation. In our patient, a focal morphologic change that consisted of vacuolar degeneration and chromatolysis of anterior horn cells was found at the levels of the spinal cord corresponding to the involved muscles. The myoclonus may be spinal in origin and due to an increased excitability of anterior horn cells during the period of sublethal injury.

This study comprises follow-up information or pathologic material, or both, from 34 adult patients with acute transverse myelopathy of unknown cause. These patients had no antecedent neurologic or underlying systemic disease. Five patients died during the first four months of illness. Follow-up information was obtained from the remaining 29 patients 5 to 42 years after onset, and postmortem material also was available in three of these cases. During follow-up a clinical diagnosis of multiple sclerosis was made in only one patient. Two thirds of the patients recovered and became ambulatory, while one third remained paraplegic. The only factor which correlated with prognosis was the observation that patients who retained tendon reflexes and posterior column function had a better recovery than those who exhibited spinal shock.

In seven patients with spastic hemiparesis and in three normal subjects, latencies of the brachioradialis reflex and forearm flexor responses to blows at the styloid process of the radius were identical. Moreover, these latencies were similar to those of independently obtained finger flexor reflexes. H reflexes, obtained only in hemiplegic arms, were of similar latency from brachioradialis and forearm flexor muscles following stimulation of the appropriate nerves. These findings indicate that the brachioradialis reflex and associated contraction of forearm flexor muscles result from independent myotatic reflexes and not from intraspinal spread.

Introduction Reflex motor responses of skeletal muscle to a variety of peripheral stimuli have long been recognized to fall into many distinctive and predictable patterns. 1 In some instances, physiological features and integrative arrangements have now been clarified to a sufficient degree that these in themselves indicate a biological meaning of the reflex responses. For example, myotatic reflexes, controlled by the gamma efferent system, clearly play an important part in postural adjustment and movement. 2 Even these, however, constitute merely a portion of the excitatory events which lead to the coordinated discharge of motoneurons in effective motor activity. 3 Other reflex responses, including some in clinical use, have been less clearly defined and, for the most part, their basic functional roles have escaped detection. Among these are superficial abdominal and plantar responses. Both are basically spinal reflexes. 4-10 The fiber spectrum of their efferent pathways is broad. 4,11 Some fibers