INTRODUCTION Mirror movements (MM) are involuntary shudders which occur at the same time as voluntary movements of the homologous contralateral muscles. They may occur alone or associated with other pathology. CLINICAL CASES. We present three new cases of congenital MM (CMM) and discuss their clinical, physiopathological and genetic aspects. Case 1. A four year old boy was brought to the clinic because he dropped things held in one hand when he tried to take things with the other. On examination it was seen that when he made a voluntary movement with one hand, the other hand made a similar movement simultaneously and involuntarily. This phenomenon had been observed since he was a few months old. Apart from this, the rest of the neurological examination was normal. Cerebral MR was also normal. Neuropsychological assessment showed borderline intellectual function. Case 2. The first patient’s father, who was 26 years old, knew no details of his own family history. Since childhood he had noticed that he himself had made similar movements to those of his son. However, with time, he had managed to partially control and even inhibit these movements. His cerebral MR scan was normal. Case 3. An 11 year old boy consulted for MM, non­fluctuating congenital palpebral ptosis and nocturnal enuresis. The neurological examination and his intelligence were found to be normal. One of his sisters had palpebral ptosis and nocturnal enuresis without MM. His cerebral MR, Xray of his spine, EMG, electroretinogram, CPK, blood lactate, glucemia, urine and urological examination were normal.

CONCLUSIONS MM may be another manifestation within the clinical spectrum of diverse encephalopathies; may be associated with different syndromes (Kallman, Klippel­Feil and Usher amongst others) or may present alone. Both familial and sporadic cases have been described. We consider our cases 1 and 2 to be of the familial CMM condition, with autosomal dominant inheritance, in which MM was the only finding. The association observed in case 3 has not previously been described. It may possibly be a condition transmitted by autosomal recessive inheritance

Introducción Los movimientos en espejo (ME) son sacudidas involuntarias que se producen de forma simultánea al movimiento voluntario de los músculos homólogos contralaterales. Pueden presentarse de forma aislada o asociarse a otras patologías.

Casos clínicos Presentamos tres nuevos casos de ME congénitos (MEC) y analizamos los aspectos clínicos, fisiopatológicos y genéticos. Caso 1. Niño de 4 años que llegó a la consulta porque se le caían los objetos sostenidos con una mano al intentar tomar algo con la otra. En el examen se constató que ante un movimiento voluntario de una de sus manos, la otra desarrollaba el mismo movimiento de forma simultánea e involuntaria. El resto del examen neurológico fue normal. Caso 2. Padre del caso 1, de 26 años. Desde la infancia presenta movimientos similares a los descritos en su hijo. Con el tiempo ha logrado controlarlos parcialmente e incluso inhibirlos. Caso 3. Varón de 11 años que acudió a la consulta por presentar ME, ptosis palpebral congénita no fluctuante y enuresis nocturna. El examen neurológico y su inteligencia eran normales.

Conclusiones Los ME pueden ser una manifestación más dentro del espectro clínico de diversas encefalopatías; asociarse a distintos síndromes (Kallman, Klippel­Feil, Usher, entre otros) o presentarse de manera aislada habiéndose descrito formas familiares y formas esporádicas. Consideramos que nuestros casos 1 y 2 corresponden a la entidad a MEC familiares, con herencia autosómica dominante y en la cual los ME constituyen la manifestación exclusiva; mientras que la asociación observada en el caso 3 no ha sido descrita hasta el momento y podría tratarse de una entidad de probable herencia autosómica recesiva