Delayed-onset hemidystonia and chorea following contralateral infarction of the posterolateral thalamus. A case report.

摘要: A 68 year-old man developed progressive hemidystonia and chorea 8 months after a contralateral thalamic stroke. The neurological examination also showed right pyramidal syndrome without hemiparesis, horizontal sectoranopia, hemihypesthesia for all sensory modalities. MRI revealed infarctions in the left medial temporo-occipital lobes posterolateral thalamus, corresponding to vascular territories of both thalamogeniculate choroidal arterial pedicles. lesion involved pulvinar, lateral geniculate body, ventro-postero-lateral, dorso-lateral, posterolateral,and dorso-medial nuclei, but apparently did not extent ventrolateral nucleus, subthalamic midbrain regions. Thalamic striatopallidal dystonia have common pathophysiological mechanism. involvement pulvinar nucleus strategic crossing proprioceptive, cerebellar pyramidal, pathways may play role genesis dystonia.