J Korean Neurol Assoc.
1997 Jun;15(3):563-575.
Dyskinesias precipiatated by peripheral trauma
- Affiliations
-
- 1Department of Neurology, Youngdong Severance Hospital.
- 2Yonsei Brain Research Center.
- 3Yonsei University College of Medicine.
- 4Department of Neurology, Kwang Hey Hospital.
Abstract
- We describe 9 patients who developed variable dyskinesias precipitated by peripheral trauma. Three of the 9 developed focal or segmental dystonia, 1 developed painful leg and moving toes syndrome, 1 developed perioral rhythmic twitchings, 1 developed hemifacial spasm, I developed causalgia-dystonia syndrome, and 2 developed psychogenic tremor. Except one who developed spasmodic dysphonia immediately after a v@l cord polypectomy, the others developed dyskinesias from a weak to 24 months after the peripheral trauma. In four dyskinesias spread to involve other parts of the body over a variable period ranging a few months to several years. Five, including two with psychogenic tremor, had persistent pain or sensory changes after the acute insult, but only one had objective evidences of autonomic involvement We suspect that peripheral trauma may precipitate sequential occurrences of reorganization or unmasking of sensorimotor cortex, inactivation of segmental inhibitory interneuron, and disinhibition of pulse generator or reciprocal inhibition, which lead to rhythmic dyskinesia or dystonia. Careful clinical observation is important to make a diagnosis of psychogenic movement disorders after a peripheral trauma, particularly in the patient with a tremor.
