title: Combined focal myoclonus and dystonia secondary to a cerebellar hemorrhage: a case report.
abstract: BACKGROUND
  Myoclonus is a clinical sign characterized by sudden, brief jerky, shock-like involuntary movements of a muscle or group of muscles. Dystonia is defined as a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal postures. Cases of myoclonus or dystonia secondary to a structural lesion in the cerebellum have been reported. However, there has never been a reported case of combined myoclonus and dystonia secondary to a cerebellar lesion.
  
  
  METHODS
  Herein, we report a 22-year-old female patient with sudden-onset myoclonic jerks, dystonic posture and mild ataxia in the right upper extremity. At age 19, she experienced sudden headache with vomiting. The neurological examination showed ataxia, myoclonus and dystonia in the right upper extremity. Brain images demonstrated a hemorrhage in the right cerebellar hemisphere secondary to a cavernous malformation. After resection of the hemorrhagic mass, headache with vomiting disappeared and ataxia improved, but myoclonus and dystonia persisted.
  
  
  CONCLUSIONS
  It is the first report of combined focal myoclonus and dystonia secondary to a cerebellar lesion.
authors.affiliation: Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.
authors.forename: Guangxun
authors.initials: G
authors.lastname: Shen
authors.affiliation: Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.
authors.forename: Guangxian
authors.initials: G
authors.lastname: Nan
authors.affiliation: Department of Neurology, SNU-SMG Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Chae-Won
authors.initials: CW
authors.lastname: Shin
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-774, Republic of Korea.
authors.forename: Hyeyoung
authors.initials: H
authors.lastname: Park
authors.affiliation: School of Medicine, University of Queensland, Brisbane, QLD, 4072, Australia.
authors.forename: Kwee-Yum
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-774, Republic of Korea. brain@snu.ac.kr.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Jeon
mesh_terms: D020201:Brain Hemorrhage, Traumatic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D004421:Dystonia / Q000209:etiology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009207:Myoclonus / Q000209:etiology*; D009460:Neurologic Examination; D055815:Young Adult
keywords: Cerebellar lesion; Dystonia; Electromyography; Magnetic resonance imaging; Myoclonus