Subtraction brain SPECT imaging in a patient with paroxysmal exercise-induced dystonia: role of the primary somatosensory cortex.
BACKGROUND
Paroxysmal exercise-induced dystonia is a rare hyperkinetic disease characterized by episodic dystonic attacks after prolonged exercise. However, its pathophysiological and anatomical basis are poorly understood.


OBJECTIVE
To explore the exact anatomical location responsible for paroxysmal exercise-induced dystonia by conducting ictal-interictal single-photon emission computed tomography subtraction, which was coregistered to the patient's own magnetic resonance image.


METHODS
This is a case report of a 16-year-old boy who developed a right foot dystonic attack following prolonged exercise. Result Subtraction single-photon emission computed tomographic imaging showed significantly increased cerebral perfusion in the medial aspect of the postcentral gyrus and mildly increased perfusion in the primary motor area and cerebellum during an attack of foot dystonia.


CONCLUSIONS
The primary somatosensory cortex may be a relevant structure in paroxysmal exercise-induced dystonia. Paroxysmal exercise-induced dystonia may result from defective processing of sensory information.
Yoon
Jung Han
JH
Department of Neurology, Ajou University School of Medicine, Woncheon-dong San 5, Yongtong-ku, Suwon, Kyunggi-do 442-749, South Korea.
Lee
Phil Hyu
PH
Yoon
Suk Nam
SN
D000293:Adolescent; D001931:Brain Mapping; D004421:Dystonia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D015444:Exercise / Q000502:physiology*; D006801:Humans; D008297:Male; D013003:Somatosensory Cortex / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon