Idiopathic Inflammatory Myopathy with Delayed Finger Opening Resembling Grip Myotonia

Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia....

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Published inInternal Medicine Vol. 62; no. 22; pp. 3397 - 3400
Main Authors Kobayashi, Shunsuke, Shimizu, Jun, Hatanaka, Yuki, Kanbayashi, Takamichi, Sonoo, Masahiro
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 15.11.2023
Japan Science and Technology Agency
Subjects
Case Report
delayed finger opening
extensor digitorum
Finger
idiopathic inflammatory myopathy
Inflammation
Internal medicine
Myopathy
Myotonia
myotonic dystrophy
idiopathic inflammatory myopathy
myotonic dystrophy
delayed finger opening
myotonia
extensor digitorum
Online AccessGet full text
ISSN0918-2918
1349-7235
1349-7235
DOI10.2169/internalmedicine.1545-22

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Abstract Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia. The delayed finger opening differed from grip myotonia given the absence of the warm-up phenomenon and percussion myotonia, relative sparing of the thumb extension, and pronounced weakness of the extensor digitorum. Focusing on the extension of the thumb and other fingers may aid in the differentiation between delayed finger opening and true grip myotonia.
AbstractList Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia. The delayed finger opening differed from grip myotonia given the absence of the warm-up phenomenon and percussion myotonia, relative sparing of the thumb extension, and pronounced weakness of the extensor digitorum. Focusing on the extension of the thumb and other fingers may aid in the differentiation between delayed finger opening and true grip myotonia.Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia. The delayed finger opening differed from grip myotonia given the absence of the warm-up phenomenon and percussion myotonia, relative sparing of the thumb extension, and pronounced weakness of the extensor digitorum. Focusing on the extension of the thumb and other fingers may aid in the differentiation between delayed finger opening and true grip myotonia.
Grip myotonia can be a clue for the diagnosis of myotonic disorders. However, several clinical conditions cause delayed finger opening mimicking grip myotonia. We herein report a 44-year-old man with idiopathic inflammatory myopathy who presented with delayed finger opening resembling grip myotonia. The delayed finger opening differed from grip myotonia given the absence of the warm-up phenomenon and percussion myotonia, relative sparing of the thumb extension, and pronounced weakness of the extensor digitorum. Focusing on the extension of the thumb and other fingers may aid in the differentiation between delayed finger opening and true grip myotonia.
ArticleNumber 1545-22
Author Sonoo, Masahiro
Kobayashi, Shunsuke
Hatanaka, Yuki
Kanbayashi, Takamichi
Shimizu, Jun
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  fullname: Hatanaka, Yuki
  organization: Department of Neurology, Teikyo University School of Medicine, Japan
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  fullname: Kanbayashi, Takamichi
  organization: Department of Neurology, Teikyo University School of Medicine, Japan
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  fullname: Sonoo, Masahiro
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Cites_doi 10.1001/archneur.1966.00470120006002
10.1016/S1097-2765(02)00563-4
10.1007/s13311-018-00678-0
10.1016/j.nmd.2004.02.006
10.1001/archneur.1972.00490160035005
10.1212/WNL.48.4.863
10.1136/jnnp.51.9.1134
10.1002/mus.24632
10.1016/j.pmr.2012.08.017
10.1016/B978-0-323-63583-7.00100-4
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Issue 22
Keywords idiopathic inflammatory myopathy
myotonic dystrophy
delayed finger opening
myotonia
extensor digitorum
Language English
License The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Correspondence to Dr.　Takamichi Kanbayashi, ta_kanba@med.teikyo-u.ac.jp
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References 8. Yabuki S, Nakaya K. Phenomenon of delayed finger opening in a case with a brain-stem lesion. Rinsho Shinkeigaku (Clin Neurol) 17: 287-292, 1977 (in Japanese).
14. Sekul EA, Chow C, Dalakas MC. Magnetic resonance imaging of the forearm as a diagnostic aid in patients with sporadic inclusion body myositis. Neurology 48: 863-866, 1997.
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2. Mankodi A, Takahashi MP, Jiang H, et al. Expanded CUG repeats trigger aberrant splicing of ClC-1 chloride channel pre-mRNA and hyperexcitability of skeletal muscle in myotonic dystrophy. Mol Cell 10: 35-44, 2002.
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11. Hoogendijk JE, Amato AA, Lecky BR, et al. 119th ENMC international workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Netherlands. Neuromuscul Disord 14: 337-345, 2004.
9. Saito Y, Wada Y, Nakayama T, Furukawa T, Tsukagoshi H. Delayed finger opening caused by a midbrain lesion. No To Shinkei (Brain Nerve) 43: 1157-1161, 1991 (in Japanese).
7. Chaco J. Cervical spondylosis and pseudomyotonia. Scand J Rehabil Med 6: 99-101, 1974.
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References_xml – reference: 1. Quinn C, Price RS. Myotonia. In: Decision-Making in Adult Neurology. 1st ed. Cucchiara BL, Price RS, Eds. Elsevier, St. Louis, 2020: 206.
– reference: 10. Suzuki K, Kawada N, Miyazaki M. Delayed finger opening in cerebral lesion. Sogo Rinsho (Clin All-round) 47: 2020-2023, 1998 (in Japanese).
– reference: 2. Mankodi A, Takahashi MP, Jiang H, et al. Expanded CUG repeats trigger aberrant splicing of ClC-1 chloride channel pre-mRNA and hyperexcitability of skeletal muscle in myotonic dystrophy. Mol Cell 10: 35-44, 2002.
– reference: 8. Yabuki S, Nakaya K. Phenomenon of delayed finger opening in a case with a brain-stem lesion. Rinsho Shinkeigaku (Clin Neurol) 17: 287-292, 1977 (in Japanese).
– reference: 9. Saito Y, Wada Y, Nakayama T, Furukawa T, Tsukagoshi H. Delayed finger opening caused by a midbrain lesion. No To Shinkei (Brain Nerve) 43: 1157-1161, 1991 (in Japanese).
– reference: 14. Sekul EA, Chow C, Dalakas MC. Magnetic resonance imaging of the forearm as a diagnostic aid in patients with sporadic inclusion body myositis. Neurology 48: 863-866, 1997.
– reference: 5. Norris FH Jr., Panner BJ. Hypothyroid myopathy. Clinical, electromyographical, and ultrastructural observations. Arch Neurol 14: 574-589, 1966.
– reference: 3. Phillips L, Trivedi JR. Skeletal muscle channelopathies. Neurotherapeutics 15: 954-965, 2018.
– reference: 4. Ahmed A, Simmons Z. Isaacs syndrome: a review. Muscle Nerve 52: 5-12, 2015.
– reference: 11. Hoogendijk JE, Amato AA, Lecky BR, et al. 119th ENMC international workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Netherlands. Neuromuscul Disord 14: 337-345, 2004.
– reference: 7. Chaco J. Cervical spondylosis and pseudomyotonia. Scand J Rehabil Med 6: 99-101, 1974.
– reference: 12. Paganoni S, Amato A. Electrodiagnostic evaluation of myopathies. Phys Med Rehabil Clin N Am 24: 193-207, 2013.
– reference: 13. Cooper RG, Stokes MJ, Edwards RH. Physiological characterisation of the "warm up" effect of activity in patients with myotonic dystrophy. J Neurol Neurosurg Psychiatry 51: 1134-1141, 1988.
– reference: 6. Satoyoshi E, Doi Y, Kinoshita M. Pseudomyotonia in cervical root lesions with myelopathy. A sign of the misdirection of regenerating nerve. Arch Neurol 27: 307-313, 1972.
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  doi: 10.1001/archneur.1966.00470120006002
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  doi: 10.1007/s13311-018-00678-0
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  doi: 10.1016/j.nmd.2004.02.006
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  doi: 10.1001/archneur.1972.00490160035005
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  doi: 10.1212/WNL.48.4.863
– ident: 13
  doi: 10.1136/jnnp.51.9.1134
– ident: 4
  doi: 10.1002/mus.24632
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  doi: 10.1016/j.pmr.2012.08.017
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delayed finger opening
extensor digitorum
Finger
idiopathic inflammatory myopathy
Inflammation
Internal medicine
Myopathy
Myotonia
myotonic dystrophy
Title Idiopathic Inflammatory Myopathy with Delayed Finger Opening Resembling Grip Myotonia
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