Dystonia caused by putamino-capsulo-caudate vascular lesions.

Abstract

SUMMARY Three cases of unilateral dystonia of vascular origin are presented and compared with those in the literature. Damage in the region of the lenticulostriate arteries accounted for ischaemic lesions of the putamino-capsulo-caudate region, the external pallidum probably also being involved. This syndrome appears if the ischaemic accident took place during childhood. The functions of each of these structures and the possible role of the anterior limb of the internal capsule are discussed.Dystonia represents a particular group of diseases involving the motor system. Denny-Brown' defined it as "a fixed or relatively fixed attitude in association with other extrapyramidal disorders of movement". Dystonia musculorum deformans is its major form, but the absence of specific pathology in this condition makes any physiopathological interpretation particularly difficult.2 However, besides this idiopathic, occasionally hereditary3 form of the disease, dystonic syndromes can occur in metabolic,4 anoxic,5 tumoural6 and infectious disorders.7 Dystonia of vascular origin is particularly interesting, because the responsible lesions may be more limited than those of metabolic or anoxic origin, thus permitting speculation on the pathological-anatomic basis of this unique motor disease. Vascular dystonia usually is unilateral, and frequently, but not necessarily, follows a hemiplegia.' 8-15 We report three cases in which the CT scan enabled us to diagnose the obliteration of a lenticulo-striate artery, causing lesions in the putamen, to the head of the caudate nucleus and to the anterior limb of the internal capsule. Case ReportsCase I A 3-year-old child without any medical, surgical or family history, had a mild head injury without loss of consciousness in 1967; 15 minutes later, the parents Address for reprint requests: Prof P Rondot,

Delayed Movement Disorders after Carbon Monoxide Poisoning

“…Although a variety of insults to the brain can result in delayed movement disorders, they usually appear after birth injury, stroke, anoxia or head trauma [3, 12, 14, 15]. The pathophysiologic mechanism of delayed movement disorders is little known, but there are several suggestions.…”

“…The pathophysiologic mechanism of delayed movement disorders is little known, but there are several suggestions. The latency between anoxic insult and onset of movement disorders may reflect the time required for remyelination, oxidation reactions, central synaptic reorganization, transsynaptic neuronal degeneration and diaschisis mediated by collateral sprouting and denervation supersensitivity to follow [2, 3, 14, 15, 16, 17]. In view of the fact that delayed dyskinesias after CO poisoning in our study usually were transient and did not relapse, delayed movements after CO poisoning may be a functional rather than an anatomical impairment of the frontosubcortical motor circuits.…”

Post-stroke movement disorders: report of 56 patients

“…nvoluntary abnormal movements (IAMs) caused by strokes are relatively common, [1][2][3][4] and chorea, [3][4][5][6][7][8][9][10][11][12][13][14][15] tremor, [16][17][18][19][20][21][22][23][24][25][26][27][28][29] dystonia, [30][31][32][33][34][35][36][37][38][39][40][41][42][43] parkinsonism, [44][45][46][47][48][49][50]…”

Therapeutic approaches and advances in pediatric stroke

“…Infarcts are frequently isolated to the basal ganglia, 3 with resultant movement disorders either at presentation or beginning within several months. 50 Posterior circulation strokes account for less than 10% of cases. 51 Compared with adults, seizures, fever, and headache are more common.…”