Posttraumatic dystonia and hemiplegic migraine: different expressions of neuronal hyperexcitability?

Neurologist. 2012 Jan;18(1):36-8. doi: 10.1097/NRL.0b013e31823d7aa9.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dystonic Disorders / etiology*
  • Female
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / metabolism
  • Hand / physiopathology*
  • Humans
  • Migraine with Aura / complications*
  • Parietal Lobe / diagnostic imaging
  • Parietal Lobe / metabolism
  • Positron-Emission Tomography
  • Whiplash Injuries / complications*