Basal ganglia arteriovenous malformation presenting as "writer's cramp"

A 12-year-old girl with a 3-year history of writer's cramp in association with a basal ganglia arteriovenous malformation (AVM) is reported. The lesion was localized to the left globus pallidus and putamen, extending to the adjacent white matter of the frontal lobe. Our experience confirms a common anatomical basis of symptomatic focal dystonia: disruption of the pathways within and adjacent to these structures. Appropriate imaging should be carried out in patients with unexplained movement disorders.