연수출혈과 연관된 국소성 이긴장증 = Focal Dystonia with Primary Medullary Hemorrhage

다국어 초록 (Multilingual 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.

참고문헌 (Reference)

1 "Upper-limb dystonia secondary to a midbrain hemorrhage" 11 : 96-99, 1996

2 "Sensorimotor integration in movement disorders" 18 : 231-240, 2003

3 "Paroxysmal kinesigenic dystonia associated with a medullary hemorrhage" 12 : 819-, 1997

4 "Neuronal basis of crossed actions from the reticular formation on feline hindlimb motorneurons" 23 : 1867-1878, 2003

5 "Motor system I: peripheral sensory, brainstem, and spinal influence on anterior horn neurons. In: Haines DE. Fundamental neuroscience" Churchill Livingstone 2002 374-385, 2002

6 "Medullary reticulospinal tract mediating the generalized motor inhibition in cats Functional organization within the medullary reticular formation with respect to postsynaptic inhibition of forelimb and hindlimb motoneurons" 65-77, 2002

7 "Medullary lesions and unusual bilateral paroxysmal dystonia in multiple sclerosis" 46 : 847-848, 1996

8 "Medullary dystonia" 14 : 698-700, 1999

9 "Dystonia update" 16 : 495-500, 2003

10 "A case of primary medullary hemorrhage" 18 : 629-631, 2000