Paroxysmal dystonia due to a lesion of the cervical cord: Case report

Abstract

A 48 year old woman complained of mild weakness and paresthesias of the left limbs, followed 15 days later by episodes of paroxysmal dystonia of the left limbs occurring several times daily over 10 day period. Magnetic resonance imaging (MRI) of head and neck revealed a small area of altered signal in the T2-weighted sequences in the left posterolateral quadrant of the cord at the second cervical vertebra. An MRI scan 18 months later showed no lesion. This is the second case of paroxysmal dystonia with a single MRI lesion in the cervical region on record.

Postoperative Cervical Dystonia: Is It an Occult Injury to the Corticospinal Tracts?

“…The authors found that the corticospinal tracts demonstrated dysfunction in all patients, while SSEPs remained normal [8] . The theory of corticospinal tract dysfunction or other long tract dysfunction, such a spinothalamic tract, is further supported by the case reports on cervical intramedullary tumors presenting with cervical dystonia [6,7] . Several studies have attempted and failed in differentiating idiopathic cervical dystonia from posttraumatic cervical dystonia [9,10] .…”

Paroxysmal dystonia and neuromyelitis optica

“…PKD associated with pure spinal cord lesions is rare 7,8 . Cosentino et al 7 reported a case of PKD associated with an intraspinal lesion.…”

Secondary paroxysmal dyskinesias

“…The most common causes of secondary PxD, identified in a review of the literature, are MS, stroke or transient cerebral ischemia, trauma, metabolic abnormalities, central nervous system (CNS) infections, and anoxic brain injuries. Additional causes reported are thyrotoxicosis,12 Arnold‐Chiari malformation with syringomyelia,13 parasagittal menigioma,14 methylphenidate therapy,15 progressive supranuclear palsy,16 and spinal cord injury 17. Early recognition of potential causes is particularly important, as symptoms may be reversed if the underlying cause is identified and treated.…”