Background: Symptomatic (secondary) dystonias associated isolated lesions in the brain provide insight into etiopathogenesis of the idiopathic form of dystonia and are a basis for establishing the possible correlation between the anatomy of a lesion and the type of dystonia according to muscles affected. Methods: In 358 patients with differently distributed dystonias, a group of 16 patients (4.5%) was encountered in whom dystonia was associated with focal brain lesions. Results: Of the 16 patients, 3 patients had generalized, 3 segmental and 4 hemidystonia, while the remaining 6 patients had focal dystonia. The most frequent etiologies were infarction in 7, and tumor in 4 patients. These lesions were usually found in the lenticular and caudate nucleus, thalamus, and in the case of blepharospasm in the upper brainstem. Conclusions: Our results support the suggestion that dystonia is caused by a dysfunction of the basal ganglia. RESUME: Dystonies symptomatiques associees a des lesions structurales du cerveau: a propos de 16 cas. Introduction: Les dystonies symptomatiques (secondaires) associees a des lesions cdrgbrales isoiees aident a comprendre la pathogenese de la forme idiopathique de dystonie et servent de base a une correlation eventuelle entie la topographie de la lesion et le type de dystonie, selon sa distribution. M4thodes: Parmi 358 patients atteints de dystonies a distribution varied, nous avons £tudie un groupe de 16 sujets (4.5%) chez qui la dystonie etait associee a des lesions focales du cerveau. Resultats: De ces 16 patients, 3 presentaient une dystonie g£n6ralisde, 3 prfisentaient une dystonie segmentaire, 4 presentaient une hemidystonie et les 6 autres prtisentaient une dystonie focale. L'etiologie la plus frequente etait un infarctus, chez 7 patients, ou une tumeur, chez 4 patients. Ces lesions se situaient le plus souvent dans les noyaux lenticulaire et caude, le thalamus, et, dans le cas du blepharospasme, dans la partie sup6rieure du tronc cerebral. Conclusion: Nos resultats appuient la notion que la dystonie est la consequence d'une dysfonction au niveau du noyau lenticulaire, du noyau caude, de l'avant-mur ou du noyau amygdalien.
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