Brainstem hypoplasia presenting with mirror movement

Abstract

A 20 year old female patient, who was operated for congenital syndactyly of her left hand at age of 5, admitted to neurology policlinic with involuntary movements of her hands. We saw mirror movement (MM) of her right hand when she was writing and catching something with her left hand. Also we saw MM of her left hand when she was doing something with her right hand with a lower amplitude. Cervical magnetic resonance imaging (MRI) revealed no abnormality. Brain MRI revealed hypoplasia of right middle, inferior cerebellary peduncle, olive and pyramis. MM shows homolog muscle activity which imitates contralateral movement, during a spesific task. This movement usually affects upper extremity especially hand. Corticospinal tract dysfunction is often considered in the pathogenesis. MM may present as part of cervicomedullary junction abnormality, cerebral palsy, cerebrovascular disease, Parkinson's disease. We wanted to discuss the pathogenesis of MM in our patient with syndactyly and MRI abnormality.