J Korean Neurol Assoc.  1998 Aug;16(4):574-577.

A Case of Transient Cervical Dystonia following Cerebellar Hemorrhage

• Lee SH
• Kim JH
• Jung WY

Abstract

BACKGROUND: Cervical dystonia is a focal dystonia characterized by painful spasmodic contractions of the neck muscles, that result in an abnormal posture of the head. Usually the pathogenesis of the disorder is unknown. Secondary cervical dystonia caused by intracranial lesions, involving the basal ganglia, thalamus or brainstem, is very rare. This is the first report of a focal cervical dystonia following cerebellar hemorrhage in Korea. CASE: We describe a 77 year-old woman presented with vertigo and vomiting followed by mild ataxia in the right extremities and cervical dystonia. She had a 25-year history of right hemiparesis due to a stroke. On physical examination, her neck turned to the right and tilted to the left shoulder. Polygraphic study revealed continuous muscular contraction of the left sternocleidomastoid and trapezius muscles without EEG changes. A brain CT scan showed right cerebellar hemorrhage and low density lesions in the left putamen.
CONCLUSION
We reported a rare case of cervical dystonia associated with cerebellar hemorrhage. Because she had an old left putaminal lesion, it is suggested that cervical dystonia seen in our patient may be caused by additional dysfunction of dentatorubrothalamocortical pathway to the pre-existing damage to the striatopallidothalamocortical pathway.

Keyword

Cervical dystonia; Cerebellar hemorrhage; Dantatorubrothalamic pathway

MeSH Terms

Aged
Ataxia
Basal Ganglia
Brain
Brain Stem
Dystonic Disorders
Electroencephalography
Extremities
Female
Head
Hemorrhage*
Humans
Korea
Muscle Contraction
Neck
Neck Muscles
Paresis
Physical Examination
Posture
Putamen
Shoulder
Stroke
Superficial Back Muscles
Thalamus
Tomography, X-Ray Computed
Torticollis*
Vertigo
Vomiting