Teaching Video NeuroImage: Myokymia on Muscle Ultrasound in Radiation-Induced Brachial Plexopathy

A 65-year-old women presented with right arm weakness and paresthesia. She had undergone radiotherapy for a supraclavicular metastasized lung cancer 8 years ago. Examination revealed weakness, wasting, and wavelike involuntary contractions in the right deltoid, triceps, and dorsal interossei muscles. EMG confirmed a brachial plexopathy with additional myokymic discharges. Spontaneous semirhythmic contractions with a rotatory or to-and-fro component were seen on muscle ultrasound, compatible with myokymia (Video 1).

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