RT Journal Article
SR Electronic
T1 Progressive delayed hemidystonia following clinically mild traumatic brain injury
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-220334
DO 10.1136/bcr-2017-220334
VO 2017
A1 Swaleha N Nadaf
A1 Rahul T Chakor
A1 Kaumil Vipul Kothari
A1 Haresh Bharote
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-220334.abstract
AB A 16-year-old boy presented with progressive left hemidystonia over 3 years. The possibilities of symptomatic hemidystonia due to focal lesions such as infarct (vasculitis), tumours, tuberculoma, arteriovenous malformations or heredodegenerative disorders such as Wilson disease were considered. Imaging showed a peculiar scar involving right basifrontal region extending upto anterior, centromedian and dorsomedial nuclei of thalamus due to blowout fracture of roof of orbit. This scar was responsible for progressive left hemidystonia. On probing the history, it was revealed that patient had sustained a mild traumatic brain injury (mTBI) 3 years ago. Burke-Fahn-Marsden dystonia severity rating scale showed improvement from 19 to 6 after treatment with tablet trihexyphenidyl 16 mg and clonazepam 1 mg. A linear scar reaching upto thalamus due to blowout fracture of roof of orbit following clinically mTBI is unique. Delayed, progressive hemidystonia has been reported following severe head injury, however is less common following clinically mTBI.