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Letter
Focal hand dystonia after cervical whiplash injury
  1. S Tamburin,
  2. G Zanette
  1. Department of Neurological Sciences and Vision, University of Verona, Italy
  1. Correspondence to:
 Dr S Tamburin, Dipartimento di Scienze Neurologiche e della Visione, Sezione di Neurologia, Policlinico G.B. Rossi, Piazzale Scuro, 37134 Verona, Italy;
 s_tamburin{at}yahoo.com

https://doi.org/10.1136/jnnp.74.1.134

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    There is currently a general consensus of agreement that dystonia is a disease of the basal ganglia, although dystonic symptoms have been observed in association with lesions in various different sites of the sensory and motor pathways.1 In particular, cervical intramedullary lesions have been reported as being a rare cause of focal hand dystonia,2 although in these cases the pathogenesis of the movement disorder remains unclear. To help clarify this point, we report the case of a patient who developed dystonic features of the right hand after a cervical whiplash injury.

    Case report

    A 44 year old man developed sensory alterations and impairment of strength in the right hand immediately after a whiplash injury. Neurological examination showed proprioceptive and tactile anaesthesia of the first three fingers of the right hand, mild hypasthenia on grasping, and adiadochokinesis of the right upper limb. Tendon reflexes, muscle tone, and plantar responses were normal, and thorough neurological examination of the upper left limb and lower limbs also yielded normal findings. Cervical magnetic resonance imaging (MRI) revealed a small right posterior C5-C6 lesion of the …

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