SHM Converge Scientific Abstract ePoster Gallery-Belly Dancer's Dyskinesia: A Novel Presentation of Abdominal Segmental Myoclonus

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This case describes a 70-year-old woman with hypereosinophilic syndrome complicated by recurrent organizing pneumonia who was hospitalized with four weeks of involuntary abdominal wall spasms and worsening hypoxemia. On exam, she had rapid, repetitive, involuntary contractions of the abdominal musculature. During these episodes, her work of breathing increased and her oxygen saturation dropped, requiring supplemental oxygen. MRI of the brain and spine showed no structural cause, while chest CT revealed ground-glass consolidation consistent with an organizing pneumonia flare.<br /><br />She was treated with prednisone 60 mg daily for the lung flare and was diagnosed with presumed abdominal segmental myoclonus (ASM), also called “belly dancer’s dyskinesia.” A trial of baclofen and cyclobenzaprine was ineffective. She then received clonazepam, starting at 0.25 mg twice daily and increasing to 0.5 mg twice daily, which led to a marked reduction in the frequency and severity of her spasms. As her abdominal movements improved and the organizing pneumonia was treated, her hypoxemia gradually resolved.<br /><br />The report highlights that ASM is a rare focal movement disorder causing writhing abdominal wall movements and should be considered in the differential diagnosis of abdominal spasms. ASM has been linked to multiple causes, including structural, autoimmune, osmotic demyelinating, and drug-induced neurologic conditions. This case is notable as the first reported ASM associated with hypereosinophilic syndrome and recurrent organizing pneumonia. It also suggests that hypoxia may worsen during ASM episodes due to impaired chest wall mechanics, in addition to the underlying interstitial lung disease flare.<br /><br />Key learning points are to include ASM in the differential for abdominal spasms, recognize it as a possible presenting feature of interstitial lung disease flares, and treat it with benzodiazepines while addressing the underlying trigger.

Asset Subtitle

Molly A. Kantor

Meta Tag

Author List Christopher A. Hill, Kimberly L. Yan, Molly A. Kantor

Category Clinical Vignettes

Concept Abdominal Segmental Myoclonus

Concept Abdominal Wall Spasm

Concept Differential Diagnosis

Concept Interstitial Lung Disease

Concept Increased Work of Breathing

Distinguished Non-Finalist

Presenter Organization University of California San Francisco

Presenting Author Molly A. Kantor

Track Adult

Keywords

hypereosinophilic syndrome

organizing pneumonia

abdominal segmental myoclonus

belly dancer's dyskinesia

hypoxemia

abdominal wall spasms

clonazepam

benzodiazepines

interstitial lung disease

ground-glass consolidation

Abdominal Segmental Myoclonus

Abdominal Wall Spasm

Differential Diagnosis

Interstitial Lung Disease

Increased Work of Breathing