Speech-activated myoclonus masquerading as stuttering.

Despite having had normal speech until age 21 when he contracted varicella encephalitis, this 53-year-old man had always considered himself a stutterer. Neurologic examination revealed lightning-like facial and neck contractions during speech, which were absent at rest (video). Brain and cervical spine MRI had normal results. Surface EMG confirmed intermittent high-amplitude, short-duration bursts suggestive of cortical myoclonus (figure and video). Speech-activated myoclonus is an unusual variant of segmental action myoclonus.1,2 The etiology in this patient was likely postinfectious, and treatment with valproic acid led to a moderate symptomatic improvement. The myoclonus occurred with speech in both English and his native Ukrainian.