Catamnesis of neurologic patients, especially dystonic
patients, features not only the natural history of certain disorder, but the
social status of these cripples. Are they always grata in the country of
healthy people? We report the catamnesis of two dystonic patients, that testify
the society to turn them often into the pariah. Case one concerns with mixed
geno – phenotype of generalized dystonia and Strumpel disease. Strumpel disease
and dystonia are inherited disorders with clinical picture of spastic paraparesis
and hyperkinesis respectively. We present a case of a patient born from parents
with these diseases who developed neurologic phenomena uncharacteristic for the
classical clinical picture of his parents’ disorders. Patient V., 12, born from
father with generalized dystonia and mother with Strumpel disease, has flaccid
lower paraplegia along with dystonic hyperkinesis in neck and arms. The flaccid
lower paraplegia could be caused by anterior horn lesion. This phenomenon is
unclear because anterior horn lesions were not diagnosed in the proband’s
parents. When we got in touch with his family to check the progress of the
treatment, we were terrified to reveal the brutal murder of his father with
generalized dystonia. And when we proceeded to catamnesis of the rest of
studied group of patients, it became clear that such violent outcome seems to
be rather the rule than exception. Case two concerns with cervical dystonia
patient with angioma of the frontal lobe and her terrible death. Structural
lesions of CNS, reported to be associated with torticollis, are mostly
restricted to cerebellum, brain stem and basal ganglia. In fact, we know only
about two documented frontal lobe mass lesions – meningiomas, associated with
torticollis. Our observation of frontal lobe cavernous angioma associated with
clinical picture of torticollis confirms the role this area could play in the
pathophysiology of involuntary movements. We report a case of patient with
torticollis associated with cavernous angioma of the right frontal lobe and
presuppose causative role of angioma in the development of our patient’s
torticollis. These both cases are the observation of very important neurologic
phenomena from one side and the contemporary social attitudes to hyperkinetic
patients from another.
Author (s) Details
Dr. Vadim Belenky Author (s) Details
ArsVita Clinic, St. Petersburg, Russia.
View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/203
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