Focal Dystonia and Lacunar Infarction of the Basal Ganglia

Abstract

Dystonia, a movement disorder first described by Oppenheim in 1911,¹ is most often of idiopathic origin. Although symptomatic dystonia related to specific pathologic processes does occur,² persistent focal dystonia secondary to a vascular lesion is uncommon.³ We report a case of focal dystonia associated with a lacunar infarction in the contralateral basal ganglia. REPORT OF A CASE A 56-year-old hypertensive man had a seven-month history of involuntary movement of his left upper extremity. The condition had begun abruptly and was not associated with weakness or sensory disturbance in the affected limb. The movements were slow and caused the patient's fingers to assume unusual positions. Activity exacerbated the movements. No other part of the body was affected. Hearing loss, vertigo, tinnitus, and mild incoordination in the left upper extremity had begun abruptly two months before the onset of the movement disorder. An audiogram confirmed a sensorineural hearing loss