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HOME > J Mov Disord > Volume 18(4); 2025 > Article
Teaching Video
 Tongue Myorhythmia as a Manifestation of IgLON 5 Disease
Abeer Goelorcid, Sahil Mehtacorresp_iconorcid, Shreshtha Guptaorcid, Dhanush Malleshorcid, Sidharth Chandorcid, Vivek Lalorcid
Journal of Movement Disorders 2025;18(4):396-396.
DOI: https://doi.org/10.14802/jmd.25161
Published online: July 18, 2025

Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, Chandigarh, India

Corresponding author: Sahil Mehta, MD, DM Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, Chandigarh 160012, India / Tel: +91-172-2756691 / E-mail: mehtasahilpgi@gmail.com
• Received: June 23, 2025   • Revised: July 1, 2025   • Accepted: July 7, 2025

Copyright © 2025 The Korean Movement Disorder Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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A 66-year-old woman with a known case of hypothyroidism and diabetes mellitus presented with involuntary movements of the tongue for one and a half years. These movements were more prominent at night and disturbed her sleep. The patient also complained of dysarthria and dysphagia to solid foods. Clinical examination revealed tongue myorhythmia and parkinsonian features; the results of the other neurological examinations were normal (Supplementary Video 1 in the online-only Data Supplement). Electromyography did not reveal any tongue fasciculations. Magnetic resonance imaging of the brain and fluorodeoxyglucose positron emission tomography findings were normal. Immunoglobulin-like cell adhesion molecule-5 (IgLON 5) antibodies were strongly positive in both the serum and cerebrospinal fluid analysis. The patient received intravenous methylprednisolone (1 g/kg for 5 days) and intravenous immunoglobulin (2 g/kg for 5 days), after which she reported 50% improvement in her symptoms. Myorhythmia in IgLON 5 disease results from brainstem dysfunction due to neuronal loss and hyperphosphorylated tau deposition in the brainstem [1-4].
The online-only Data Supplement is available with this article at https://doi.org/10.14802/jmd.25161.
Video 1.
This video demonstrates myorhythmia involving mainly the tongue muscles. Parkinsonian features, such as mask-like facies and bradykinesia (right>left) with decreased arm swing on the right side, are also shown in the video.

Ethics Statement

We also confirm that the patient’s guardian has given written informed consent for the publication of his video.

Conflicts of Interest

The authors have no financial conflicts of interest.

Funding Statement

None

Acknowledgments

None

Author Contributions

Conceptualization: Sahil Mehta. Data curation: Abeer Goel, Sahil Mehta, Shreshtha Gupta, Dhanush Mallesh, Sidharth Chand. Formal analysis: Abeer Goel, Sahil Mehta. Investigation: Shreshtha Gupta, Dhanush Mallesh, Sidharth Chand. Supervision: Vivek Lal. Writing—original draft: Abeer Goel, Sahil Mehta. Writing—review & editing: Sahil Mehta.

  • 1. Gaig C, Compta Y, Heidbreder A, Marti MJ, Titulaer MJ, Crijnen Y, et al. Frequency and characterization of movement disorders in anti-IgLON5 disease. Neurology 2021;97:e1367–e1381.PubMedPMC
  • 2. Vetter E, Olmes DG, Linker R, Seifert F. Teaching video neuroImages: facial myokymia and myorhythmia in anti-IgLON5 disease: the bitten lip. Neurology 2018;91:e1659.PubMed
  • 3. Gurram S, Holla VV, Kamath SD, Prakash SS, Dubbal R, Kamble N, et al. Facio-lingual-palatal myorhythmic presentation of anti-IgLON5 disease. Mov Disord Clin Pract 2023;10:1427–1429.PubMedPMC
  • 4. Ardila Jurado E, Kägi G, Brugger F. Tongue myorhythmia and palatal tremor as the main clinical manifestation in anti-IgLON5 disease. Mov Disord Clin Pract 2023;10(Suppl 3):S61–S62.PubMedPMC

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