Focal limb dystonia in a patient with a cerebellar mass.
BACKGROUND
Focal dystonia of acute onset is indicative of a structural lesion in the nervous system. Cerebellar lesions have rarely been associated with dystonia.


METHODS
A 42-year-old woman was admitted to the neurology ward because of fever, confusion, and gait unsteadiness. She was diagnosed as having tuberculous meningitis, and, after a few days of antituberculous treatment, she developed prominent dystonia of the left upper limb. Cranial nuclear magnetic resonance imaging showed an isolated lesion compatible with a tuberculoma in the left cerebellar hemisphere. Both the limb dystonia and the tuberculoma resolved with maintained antituberculous treatment.


CONCLUSIONS
In the patient described, the presence of upper-limb dystonia ipsilateral to a focal cerebellar lesion and the resolution of the dystonia and the mass lesion following treatment suggest that the cerebellum or its connections to the thalamus and/or basal ganglia could be involved in the pathophysiology of the dystonia.
Alarcón
F
F
Department of Neurology, Eugenio Espejo Hospital, PO Box 17-07-9515, Quito, Ecuador. falarcon@ramt.com
Tolosa
E
E
Muñoz
E
E
D000208:Acute Disease; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D002526:Cerebellar Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D004421:Dystonia / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016862:Tuberculoma, Intracranial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents