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Dystonia after head trauma

M S Lee1, J O Rinne, A Ceballos-Baumann

  • 1University Department of Neurology, Institute of Neurology, Queen Square, London, UK.

Neurology
|August 1, 1994
PubMed
Summary
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Head trauma can rarely cause dystonia, a movement disorder. This study found that the delay between injury and dystonia onset was longer after severe head injuries, often affecting the basal ganglia or thalamus.

Area of Science:

  • Neurology
  • Neuroscience
  • Movement Disorders

Background:

  • Dystonia is an infrequent outcome of head trauma.
  • Previous literature on this topic is limited.

Purpose of the Study:

  • To describe the characteristics of dystonia following head trauma.
  • To investigate the relationship between head injury severity and the latency to dystonia onset.
  • To identify potential neuroanatomical correlates of post-traumatic dystonia.

Main Methods:

  • Case series of 10 patients with post-traumatic dystonia.
  • Literature review of 19 additional reported cases.
  • Analysis of clinical presentation, injury characteristics, time course, and neuroimaging findings (CT/MRI).

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Main Results:

  • Twenty-nine cases were analyzed, with most head injuries occurring in the first two decades of life.
  • A longer delay between head trauma and dystonia onset was observed in severe (median 18 months) versus mild (median 14 days) head injuries.
  • Dystonia often began focally and progressed to segmental, multifocal, or generalized forms. Lesions were frequently found in the contralateral basal ganglia or thalamus, though two scans were normal.

Conclusions:

  • Head trauma, particularly in younger individuals, can lead to various forms of dystonia.
  • The severity of head injury influences the time to dystonia development.
  • Dysfunction within the lenticulothalamic neuronal circuit is implicated in the pathogenesis of post-traumatic dystonia.