Abstract
In this paper we propose that a tremor occurring over a thoracic myotomal region as representative of a motor manifestation of thoracic radicular injury. We term this process thoracic neuromuscular oscillation. It is characterized by synchronous firing of the unilateral oblique muscles at one or more adjacent thoracic myotomal distributions at a frequency of 8 to 10 Hz. Six cases of observed regular continuous abdominal wall muscular tremor occurring after traumatic thoracic spine pathology are presented. These cases were drawn retrospectively from patient files obtained over 20 years. We refer to this tremor, measured to be 8–10 Hz, as thoracic neuromuscular oscillation. The neuromuscular oscillation was influenced by mechanical forces, specifically spine loading in either a bending or compressive mode. In some cases, cervical position modulated the tremor. Other examples of thoracic spine pathology that occurred comorbid to thoracic neuromuscular oscillation are noted.
Highlights
Myotomal manifestations of thoracic radicular injury remain largely unreported in the medical literature
Descriptions of thoracic radicular injury are generally framed within the context of dermatomal sensations of pain, numbness, paresthesias and dysesthesias.[1]
In this paper we propose that a tremor occurring over a thoracic myotomal region as representing a motor manifestation of thoracic radicular injury
Summary
Myotomal manifestations of thoracic radicular injury remain largely unreported in the medical literature. Descriptions of thoracic radicular injury are generally framed within the context of dermatomal sensations of pain, numbness, paresthesias and dysesthesias.[1] By contrast, in the literature on cervical and lumbar radicular nerve injury, the motor impairment of weakness through predictable myotomal patterns is widely known. In this paper we propose that a tremor occurring over a thoracic myotomal region as representing a motor manifestation of thoracic radicular injury. We term this process thoracic neuromuscular oscillation. It is characterized by synchronous firing of the unilateral oblique muscles at one or more adjacent thoracic myotomal distributions at a frequency of 8 to 10 Hz. A more extensive variant involving the entire abdominal wall at the same frequency is described. Paresthesias or dysesthesias are present in some but not all cases
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