†Spasmodic torticollis due to a midbrain lesion in a case of multiple sclerosis
Corresponding Author
Dr. G. T. Plant
The National Hospital for Nervous Diseases, Queen Square, London, England
National Hospital for Nervous Diseases, Queen Square, London WC1N 3BG, U.K.Search for more papers by this authorA. G. Kermode
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorE. P. G. H. du Boulay
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorW. I. McDonald
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorCorresponding Author
Dr. G. T. Plant
The National Hospital for Nervous Diseases, Queen Square, London, England
National Hospital for Nervous Diseases, Queen Square, London WC1N 3BG, U.K.Search for more papers by this authorA. G. Kermode
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorE. P. G. H. du Boulay
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorW. I. McDonald
The National Hospital for Nervous Diseases, Queen Square, London, England
Search for more papers by this authorA videotape segment accompanies this article.
Abstract
A case of multiple sclerosis is described in which spasmodic torticollis occurred abruplty and abated after 1 year. Magnetic resonance imaging (MRI) demonstrated a lesion in the mesencephalon. Other symptoms and physical signs that developed at the same time as the spasmodic torticollis were compatible with the lesion that had not been present on MRI 18 months previously. There are very few reports of spasmodic torticollis due to an identified focal lesion; there is evidence form experimental work on animals that midbrain lesions may cause spasmodic torticollis but there has been no previous human example.
References
- 1 Young IR, Hall AS, Pallis CA, Legg NJ, Bydder GM Steiner RE. Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 1981; ii: 1063–6.
- 2 Ormerod IEC, Miller DH, McDonald WI et al. The role of MRI in the assessment of multiple sclerosis and isolated neurological lesions: a quantitative study. Brain 1987; 110: 1579–616.
- 3 Guillain G, Bize R. Sur un cas de sclerose an plaques avec torticolis spasmodique. Rev Neurol 1933; 40: 133–8.
- 4 Herz E Glaser GH. Spasmodic torticollis. Arch Neurol Psychiatry 1949; 61: 227–39.
- 5 Boisen E. Torticollis caused by an infratntorial tumour: three cases. Br J Psychiatry 1979; 134: 306–7.
- 6 Kiwak KJ, Deray MJ Shields WD. Torticollis in three children with syringomyelia and spinal cord tumour. Neurology (Cleveland) 1983; 33: 946–8.
- 7 Maki Y, Akimoto H, Enomo T. Injuries of basal ganglia following head trauma in children. Child's Brain 1980; 7: 133–23.
- 8 Marsden CD, Obeso JA, Zarranz JJ Lang AE. The anatomical basis of symptomatic hemidystonia. Brain 1985; 108: 463–83.
- 9 Jancovic J Patel SC. Blepharospasm associated with barin stem lesions. Neurology 1983; 33: 1237–40.
- 10 Leenders KL, Frackowiak RSJ, Quinn N, Brooks D, Sumner D Marsden CD. Ipsilateral blepharospasm and contralateral hemidystonia and parkinsonism in a patient with a unilateral rostral brainstem-thalamic lesion: structural and functional abnormalities studied with CT, MRI and PET scanning. Movement Disorders 1986; 1: 51–8.
- 11 Tarlov E. On the problem of the pathology of spasmodic torticollis in man. J Neurol Neurosurg Psychiatry 1970; 33: 457–63.
- 12 Zweig RM, Hedreen JC, Jankel WR, Casanova MF, Whitehouse PJ Price DL. Pathology in brainstem regions of individuals with primary dystonia. Neurology (Cleveland) 1988; 38: 702–6.
- 13 Gibb WRG, Less AJ Marsden CD. Pathological report of four patients presenting with cranial dystonias. Movement Disorders 1988; 3: 211–21.
- 14 Carrea RME Mettler FA. Function of the primate brachium conjunctivum and related structures. J Comp Neurol 1955; 102: 565–689.
- 15 Carpenter MB. A study of the red nucleus in the rhesus monkey. Anatomic degeneration and physiological effects resulting form localised lesions of the red nucleus. J Comp Neurol 1956; 105: 195–249.
- 16 Foltz EL, Knopp CM Ward AA. Experimental spamodic torticollis J Neurosurg 1959; 16: 55–72.
- 17 Kemberling SR, Baird HW Spiegel EA. Experimental torticollis of mesencephalic origin. J Neuropath Exp Nerurol 1952; 11: 184–91.
- 18 Northington P, Barrera SE. Effects of unilateral and bilateral labyrinthectomy and intracranial section of eighth nerve: experiments on monkeys. Arch Neurol Psychiartry (Chicago) 1934; 32: 51–71.
- 19 Tarlov E. The postural effect of lesions of the vestibular nuclei: a note on the species differences among primates. J Neurosurg 1969; 31: 187–95.
- 20 Anden N-E, Dahlstrom A, Fuxe K, Larsson K. Functional role of nigroneostriatal dopamine neurons. Acta Pharmacol 1966; 24: 263–74.
- 21 Sambrook MA, Crossman AR, Slater P. Experimental torticollis in the marmoset produced by injection of 6-hydroxdopamine into the ascending nigrostrital pathway. Exp Neurol 1979; 63: 583–93.
- 22 Malouin F, Bédard P. Evaluation of head motility and posture in cats with horizontal torticollis. Exp Neurol 1983; 81: 559–70.
- 23 Zweig RM, Hedreen JC. Brainstem pathology in cranial dystonia. In: J Jankovic, E Tolosa, eds. Facial dyskinesias (Advances in Neurology; vol 49). New York: Reven, Press, 1988; 395–408.
