INVESTIGADORES
PEREZ LLORET Santiago
congresos y reuniones científicas
Título:
Shot put like paroxysmal arm dystonia.
Autor/es:
ANGEL CAMMAROTA; GUSTAVO RAGGIO; DANIEL CERQUETTI; SANTIAGO PEREZ-LLORET; MARCELO MERELLO
Lugar:
Paris, Francia
Reunión:
Congreso; Congreso Internacional de Movimientos Anormales; 2009
Resumen:
Objective: To describe patients with arm dystonia who remain in the initial position ofathletes during shot putting.Background: shot put is an athletic discipline that requires of the skillful ability ofputting (tossing) a heavy metal ball (called the shot) as far as possible into the field.When ready to initiate the toss athletes hold the shot with one hand in close proximityto the neck below the chin, whilst he/she gains momentum before releasing the shot.Methods: Retrospective clinical evaluationResults: Case I. A 18 year old female patient suffering primary DYT1 generalizeddystonia underwent GPi-DBS combined with contralateral pallidotomy at the age of 11with a remarkable response and total improvement of upper limbs dystonia. Six mothsago coincidentally with DBS battery wore off patient suddenly started with dystonicmovement of the right upper limb consistent with finger flexion, wrist hyperextensionforearm pronation and flexion and arm rotation, abduction and flexion. Placing the handin close and tight contact with the neck/chin with elbow pointing upward and forwardimitating the initial shot resting position of shot put athletes. Position was not constantbut triggered by minimal voluntary movements in a paroxysmal way. EMG recordingconfirmed co-contraction. After battery replacement described dystonic movementcompletely disappeared returning to her previous clinical state.Case II. A 23 year old female who at the age of 5 suffered from hemidystoniahemiparesis secondary to brain trauma started in the last year with an increment of herright upper limb dystonia, progressively started with dystonic movement of the rightupper limb consistent with finger flexion, wrist hyperextension forearm pronation andflexion and arm rotation, abduction and flexion. Placing the hand in close and tightcontact with the neck/chin with elbow pointing upward and forward very similar theinitial shot resting position of shot put athletes. Paroxysm of this dystonic movementlasted a few minutes appeared almost every hour. EMG recording confirmedco-contraction. Patient is on trial of anticholinergic with poor response waiting forbotulinum toxin treatment.Conclusions: This report illustrates a paroxistic dystonic arm movement in primary andsecondary dystonia patients which remains similar to the unusual position of shot putathletes.