Breathing Muscles Produces a “Dystonia Like” Contraction Khushnuma A Mansukhani<sup>1</sup>, Mukund R Thatte<sup>2</sup>, Alika Sharma<sup>1</sup>, Lajita Balakrishnan<sup>3</sup>, Priyanka Chavan<sup>1</sup> - Ann Indian Acad Neurol

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Breathing Muscles Produces a “Dystonia Like” Contraction Khushnuma A Mansukhani¹, Mukund R Thatte², Alika Sharma¹, Lajita Balakrishnan³, Priyanka Chavan¹ ¹ Department of Clinical Neurophysiology (ENMG & EP), Bombay Hospital, Mumbai, India ² Plastic Surgery, Bombay Hospital, Mumbai, India ³ Department of Neurophysiology, Apollo Hospital, Navi Mumbai, Maharashtra, India Correspondence Address: Khushnuma A Mansukhani, Bombay Hospital, Emg Department, 2^nd floor, MRC, Building 12, Marine Lines, Mumbai 0400020, Maharashtra India Source of Support: None, Conflict of Interest: None DOI: 10.4103/aian.AIAN_485_20

Birth brachial plexopathy (BBP) can cause severe weakness requiring surgical treatment, involving nerve repair by various modalities. As recovery occurs, misdirection of motor fibres to antagonist muscles often leads to co-contractions which restrict function. Mis-direction of fibres from phrenic nerve, respiratory centres and/or upper (T1 T2) thoracic nerves to limb muscles can cause a “breathing muscle”. “Breathing muscle” (BM) or respiratory synkinesis is when a limb muscle shows motor unit activity on needle electromyography (or spontaneous twitching) associated with respiration-specially inspiration. These 2 cases shows the utility of needle electromyography in detecting breathing muscles responsible for causing reducible unbalanced joint posture (a persistent “dystonia” like posture) in two children with post-surgery recovering BBP. The function at these joints was significantly affected and hence identifying the cause of the disability helped to suggest appropriate treatment.

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    -  Mansukhani KA
    -  Thatte MR
    -  Sharma A
    -  Balakrishnan L
    -  Chavan P

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