Focal Dystonia with Primary Medullary Hemorrhage

ABSTRACT

We report a patient with hand dystonia related with primary medullary hemorrhage. A 69-year-old man presented with dysarthria, right facial palsy, limb paresthesia, and limb ataxia of acute onset. Neurologic examination revealed abnormal tonic posturing of the right hand and wrist that persisted while at rest. Brain MRI showed acute hemorrhage at the right posteromedial medulla oblongata extending to the upper cervical cord. Ipsilateral limb dystonia might result from the interruption of the reticulospinal tract, sensory or olivocerebellar pathway.