[Severe generalized dystonia due to postradiotherapy cerebral calcifications].
BACKGROUND
Cerebral calcifications are a cause of secondary dystonia and may be an uncommon complication of radiotherapy. We report a very severe case of generalized dystonia due to postradiotherapy basal ganglia calcifications.


METHODS
An 8-year-old girl received 53 grays radiotherapy after surgery for craniopharyngioma. One year later she developed generalized dystonia. Computed tomography showed bilateral basal ganglia calcifications, especially of the lenticular nuclei. Pharmacological treatment with tetrabenazine, clonazepam and trihexiphenydile allowed a very limited improvement of dystonia; the course was complicated by dystonic storms and decompensations resulting from the iatrogenous panhypopituitarism.


CONCLUSIONS
This case illustrates a severe complication of cranial irradiation which should be considered in the indications of this treatment, especially for children.
Département de neurologie, hôpital civil, hôpitaux universitaires, 1, place de l'hôpital, 67091 Strasbourg, France. jb.chanson@ifrance.com
J-B
JB
Chanson
M
M
Anheim
O
O
Lagha-Boukbiza
M
M
Fleury
F
F
Sellal
C
C
Tranchant
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001479:Basal Ganglia / Q000473:pathology; D001932:Brain Neoplasms / Q000150:complications / Q000532:radiotherapy; D002114:Calcinosis / Q000150:complications* / Q000209:etiology* / Q000473:pathology; D002648:Child; D002998:Clonazepam / Q000627:therapeutic use; D003397:Craniopharyngioma / Q000150:complications / Q000532:radiotherapy; D004421:Dystonia / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D013747:Tetrabenazine / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014282:Trihexyphenidyl / Q000627:therapeutic use
D018726:Anti-Dyskinesia Agents; D018757:GABA Modulators; D002998:Clonazepam; D014282:Trihexyphenidyl; D013747:Tetrabenazine