Valero C, Sánchez Roy R, Bosca M, Burguera Ja
Sección de Neurología. Hospital Arnau de Vilanova. Valencia, Spain.
Neurologia. 2007 Dec;22(10):903-5.
Adult-onset primary focal foot dystonia is a rare event. Up to now, only 7 cases have been reported in the literature. Since the idiopathic-type food dystonia is uncommon in adults, secondary types must be ruled out.
We present the case of a 51 year woman with a 3 year history of focal food dystonia. She had abnormal posture of the foot with plantar flexion and inversion, which worsened with action. Complementary studies aimed at ruling out secondary causes were all negative. The dystonia remained limited to her food and she did not develop any other neurological symptoms. She benefited from botulinum toxin treatment.
Primary focal foot dystonia is uncommon in adults. The most common pattern is plantar and five toes flexion. Associated pain is common. Its pathogenesis is only partially understood, the neurophysiologic studies and functional resonance showing a loss of inhibitory control at spine and brainstem levels, abnormal cortical plasticity and altered sensorimotor integration. The response of this disorder to drugs is poor, however, the patients may benefit from botulinum toxin infiltrations of the muscles involved.
成人起病的原发性局灶性足部肌张力障碍是一种罕见病症。截至目前，文献中仅报道过7例。由于特发性足部肌张力障碍在成人中并不常见，因此必须排除继发性类型。
我们报告一例51岁女性，患有局灶性足部肌张力障碍3年。她足部姿势异常，表现为跖屈和内翻，且在活动时加重。旨在排除继发性病因的辅助检查结果均为阴性。肌张力障碍仅局限于足部，未出现任何其他神经症状。她接受肉毒杆菌毒素治疗后病情好转。
原发性局灶性足部肌张力障碍在成人中并不常见。最常见的表现形式是跖屈和五趾屈曲。常伴有疼痛。其发病机制仅部分为人所知，神经生理学研究和功能磁共振成像显示，在脊髓和脑干水平存在抑制控制丧失、皮质可塑性异常以及感觉运动整合改变。这种疾病对药物的反应较差，不过，患者可能会从受累肌肉的肉毒杆菌毒素注射治疗中获益。
