Clinical Pearls - how my patients taught me: The fainting lark symptom

A Kuiper; M E van Egmond; M P M Harms; M D Oosterhoff; B van Harten; D A Sival; T J de Koning; M A J Tijssen

doi:10.1186/s40734-016-0045-8

Clinical Pearls - how my patients taught me: The fainting lark symptom

A Kuiper, M E van Egmond, M P M Harms, M D Oosterhoff, B van Harten, D A Sival, T J de Koning, M A J Tijssen

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Abstract

BACKGROUND: Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.

CASE PRESENTATION: We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.

CONCLUSION: This patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as 'the fainting lark'.

Original language	English
Number of pages	3
Journal	Journal of clinical movement disorders
Volume	3
Issue number	16
DOIs	https://doi.org/10.1186/s40734-016-0045-8
Publication status	Published - 2016

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Journal Article

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title = "Clinical Pearls - how my patients taught me: The fainting lark symptom",

abstract = "BACKGROUND: Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.CASE PRESENTATION: We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.CONCLUSION: This patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as 'the fainting lark'.",

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author = "A Kuiper and {van Egmond}, {M E} and Harms, {M P M} and Oosterhoff, {M D} and {van Harten}, B and Sival, {D A} and {de Koning}, {T J} and Tijssen, {M A J}",

year = "2016",

doi = "10.1186/s40734-016-0045-8",

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journal = "Journal of clinical movement disorders",

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T1 - Clinical Pearls - how my patients taught me

T2 - The fainting lark symptom

AU - Kuiper, A

AU - van Egmond, M E

AU - Harms, M P M

AU - Oosterhoff, M D

AU - van Harten, B

AU - Sival, D A

AU - de Koning, T J

AU - Tijssen, M A J

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.CASE PRESENTATION: We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.CONCLUSION: This patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as 'the fainting lark'.

AB - BACKGROUND: Compulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.CASE PRESENTATION: We describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.CONCLUSION: This patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as 'the fainting lark'.

KW - Journal Article

U2 - 10.1186/s40734-016-0045-8

DO - 10.1186/s40734-016-0045-8

M3 - Article

C2 - 27822381

SN - 2054-7072

VL - 3

JO - Journal of clinical movement disorders

JF - Journal of clinical movement disorders

IS - 16

ER -

Clinical Pearls - how my patients taught me: The fainting lark symptom

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