Acute Onset Dystonia after Infarction of Premotor and Supplementary Motor Cortex.
OBJECTIVE
Poststroke dystonia is the second most common movement disorder after chorea and often has a delayed manifestation. Lesions of the contralateral lenticular nucleus, particularly the putamen, have been implicated in the pathogenesis of dystonia. We present an unusual case of rapid onset of focal dystonia of the left upper extremity, which developed after infarction of the right premotor cortex (PMC) and the supplementary motor area (SMA).


METHODS
A retrospective chart review of the patient was performed.


CONCLUSIONS
We propose that disruption of the afferents from PMC and SMA in the setting of chronic striatal abnormality can result in acute dystonia due to disinhibition of the thalamocortical circuit.
Department of Neurology, Wayne State University, Detroit, Michigan. Electronic address: monica.dhakar@yale.edu.
Monica B
MB
Dhakar
Department of Pediatric and Neurology, Wayne State University, Detroit, Michigan.
Carla
C
Watson
Department of Neurology, Wayne State University, Detroit, Michigan.
Kumar
K
Rajamani
D020520:Brain Infarction / Q000150:complications* / Q000473:pathology; D004421:Dystonia / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology*
Dystonia; poststroke; premotor cortex; supplementary motor area