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To the Editor.—
Faden and Towsend, in the April issue of the Archives (33:278, 1976), consider myoclonus a confusing sign in early differential diagnosis of Alzheimer and Crutzfeld-Jakob diseases. They overlooked our own publication (Neurology 13:811-823, 1963) in which we called attention to the association between myoclonus and Alzheimer disease. The observation of neurofibrillary tangles in the anterior horn cells in such cases suggests that the myoclonus may arise in the spinal cord, as well as in the cerebrum. In addition, the appearance of myoclonus probably depends on the rate of progression and eventual distribution of neuronal degeneration, rather than the disease process.
R. G. Feldman. Myoclonus and Alzheimer Disease. Arch Neurol. 1976;33(10):730. doi:10.1001/archneur.1976.00500100064023