Ipsilateral blepharospasm and contralateral hemidystonia and parkinsonism in a patient with a unilateral rostral brainstem– thalamic lesion: Structural and functional abnormalities studied with CT, MRI, and PET scanning

Abstract

A patient developed progressive right hemidystonia in childhood. Subsequently, left-sided blepharospasm, slurred and stuttering speech, and right-sided rigidity and bradykinesia, responsive to dopamine agonists, appeared. Investigation with computed tomography and magnetic resonance imaging (MRI) at age 43 years revealed a left-sided calcified rostral brainstem-thalamic lesion of uncertain aetiology. Although no structural lesion was seen in the striatal regions, L-[18F]-fluorodopa uptake was severely diminished in the left striatum but normal on the right. Dopamine receptor binding identified by [11C]-methylspiperone was in the normal range on both sides.

The natural history and treatment of acquired hemidystonia: report of 33 cases and review of the literature

“…Leenders et al proposed that the delayed development of dystonia may be related to "slowly evolving" aberrant neuronal sprouting. 58 In our review, the latency was longest when hemidystonia was secondary to perinatal injury. This may be related to the greater ability of the developing brain to recover from cerebral insults, or secondary to a delayed recognition of this syndrome in young children.…”

Stuttering: a dynamic motor control disorder

“…These lesion data do not demonstrate that any one brain region is more likely involved in the acquisition of stuttering. Many of the more recent studies, which used neuroimaging, reported involvement of the basal ganglia, with the putamen being listed most often (Abe, Yokoyama, & Yorifji, 1992;Andy & Bhatnagar, 1991;Carluer et al, 2000;Ciabarra, Elkind, Roberts, & Marshall, 2000;Heuer, Sataloff, Mandel, & Travers, 1996;Kono, Hirano, Ueda, & Nakajima, 1998;Lebrun, Leleux, & Retif, 1987;Leenders et al, 1986;Ludlow et al, 1987;Shibuya, Wakayama, Murahashi, Aoki, & Ozasa, 1998). A few other studies have reported injuries involving the corpus callosum (Hagiwara, Takeda, Saito, Shimizu, & Bando, 2000;Soroker, Bar-Israel, Schechter, & Solzi, 1990;Tsumoto, Nishioka, Nakakita, Hayashi, & Maeshima, 1999).…”

Electromyography and recovery of the blink reflex in involuntary eyelid closure: a comparative study.

“…Blepharospasm may occur in diseases of the basal ganglia or in association with upper brain stem abnormalities. [1][2][3][4][5][6][7][8] In most patients, however, it is idiopathic in origin.…”