Dystonia-like Movement Disorders Ameliorated by Shear Force and Pressure Stimulation after Small Infarction in the Left Posterolateral Thalamus

Intern Med. 2023 Mar 15;62(6):893-902. doi: 10.2169/internalmedicine.9543-22. Epub 2022 Aug 20.

Abstract

Focal dystonia (FD) can develop after thalamic lesions. Abnormal somatic sensations were argued to be responsible for FD. Our patient experienced FD-like movement disorders, agraphesthesia, and a reduced sense of shear force on the skin and pressure to deep tissues of the right upper limb following a small infarction in the left posterolateral thalamus. FD-like symptoms improved while the skin was being pulled or the deep tissue was being pushed in a manner proportional to the strength of muscle contractions. Therefore, the lack of these sensations was suggested to be related to FD-like symptoms.

Keywords: deep pressure sensation; focal dystonia; shear force; thalamus.

MeSH terms

  • Dystonia*
  • Dystonic Disorders* / etiology
  • Dystonic Disorders* / pathology
  • Dystonic Disorders* / therapy
  • Humans
  • Infarction
  • Movement Disorders* / pathology
  • Thalamus / diagnostic imaging