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Movement Disorder Emergencies pp 231–237Cite as

Whipple’s Disease

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Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Patient 1: A 55-year-old-man developed right facial twitching followed 6 months later by somnolence, blurred vision, and imbalance. He noticed that the facial twitching spread to his neck and tongue, and his family noticed that it persisted in sleep. He then developed dysarthria and complained of poor memory, change in personality, malaise, intermittent fevers, increased sweating, and impotence over the ensuing 6 months. On initial assessment 1 year after the onset of facial twitching, orientation, memory, and language were normal. He was intermittently inattentive and had marked dysarthria resulting from rhythmic lingual retraction and masticatory myorhythmia coinciding with rhythmic contractions of the right side of the face, neck, chest, and the right arm. The contractions spread irregularly to the left side of the face, chest, arm, and leg. Vertical gaze was limited, but improved with the oculocephalic maneuver. Saccades were slow in all directions. Pendular vergence oscillations of the right more than the left eye (frequency = 1 Hz) occurred synchronously with masticatory and skeletal myorhythmia (i.e., oculofacial-skeletal myorhythmia). Muscle tone, strength, sensation, deep tendon reflexes, plantar responses, and postural stability were normal. His gait was mildly ataxic.

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Authors and Affiliations

  1. Beaumont Hospital, Ireland

    John Lynch MD. MRCPI

  2. The Mater Misericordiae Hospital, Dublin, Ireland

    Tim Lynch MD. MRCPI, BSc, FRCPI

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  1. John Lynch MD. MRCPI
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  2. Tim Lynch MD. MRCPI, BSc, FRCPI
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© 2005 Humana Press Inc.

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Lynch, J., Lynch, T. (2005). Whipple’s Disease. In: Movement Disorder Emergencies. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-902-8:231

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  • DOI: https://doi.org/10.1385/1-59259-902-8:231

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-305-3

  • Online ISBN: 978-1-59259-902-8

  • eBook Packages: MedicineMedicine (R0)

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