Posttraumatic dystonia and hemiplegic migraine: different expressions of neuronal hyperexcitability?
The development of focal hand dystonia after a traumatic injury of the central or the peripheral nervous system is a rare condition with multifactorial predisposing factors. We report on a patient who developed focal dystonia of the left hand after a cervical whiplash injury. Magnetic resonance imaging did not show cerebral or spinal lesions, whereas a brain F-FDG PET scan revealed hypometabolism of the right primary sensory-motor cortex extending to the inferior and superior parietal lobule. The patient had a history of recurrent migraine attacks. Four months before the whiplash injury, she had transient dystonic posture of the left hand during a hemiplegic migraine attack. Brain magnetic resonance imaging scan and neurovascular investigations were negative. Among the predisposing factors to the development of trauma-induced dystonia, a putative role of neuronal hyperexcitability, shared by migraine and dystonia, is discussed.
Department of Neurosciences, University of Padova, Via Giustiniani 5, Padua, Italy. annachiara.cagnin@unipd.it
Annachiara
A
Cagnin
Elisabetta
E
Gasparoli
Luca
L
Santelli
Andrea
A
Marcante
Chiara
C
Briani
D000328:Adult; D020821:Dystonic Disorders / Q000209:etiology*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D020325:Migraine with Aura / Q000150:complications*; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D049268:Positron-Emission Tomography; D014911:Whiplash Injuries / Q000150:complications*