Pandey Sanjay, Tater Priyanka
Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, IN.
Tremor Other Hyperkinet Mov (N Y). 2019 Jan 8;8:610. doi: 10.7916/D8RB8NJC. eCollection 2018.
Lingual dystonia is extremely rare following stroke. We describe clinical features and neuroimaging findings in a series of 11 patients (seven acute and four chronic) with post-stroke lingual dystonia and review the literature.
This was a case series using a preformed structured proforma and review of literature using a PubMed search.
In our case series, all patients had dysarthria as a presenting symptom. Seven patients had acute presentation (six had an ischemic infarct and one had thalamic hemorrhage) and four had chronic presentation (all had infarct). All patients except one had small infarcts, with the majority of them in the basal ganglia and subcortical white matter regions. Additional chronic ischemic lesions were seen in all patients with acute presentation. The majority of the patients with acute (five out of seven; 71.42%) presentation had left-sided involvement on imaging. We could identify only one case of acute post-stroke lingual dystonia following the PubMed search. Three other cases of post-stroke lingual dystonia with chronic presentation have been described; however, these were associated with oromandibular or cranial dystonia.
Our results, based on brain lesions, suggest that all lingual dystonia patients with acute infarcts had underlying chronic infarcts. Overall, more left-sided than right-sided strokes were observed with post-stroke lingual movement disorders including dystonia; however, the data were not significant (p = 1). All patients had dysarthria, with only one having mild tongue weakness and only four having facial weakness. This suggests that the lingual dystonia was responsible for the dysarthria rather than weakness in these patients.
中风后发生舌肌张力障碍极为罕见。我们描述了一系列11例（7例急性和4例慢性）中风后舌肌张力障碍患者的临床特征和神经影像学表现，并对文献进行了综述。
这是一个使用预先制定的结构化表格的病例系列研究，并通过PubMed搜索对文献进行综述。
在我们的病例系列中，所有患者均以构音障碍为首发症状。7例患者为急性起病（6例为缺血性梗死，1例为丘脑出血），4例为慢性起病（均为梗死）。除1例患者外，所有患者均有小梗死灶，其中大多数位于基底节和皮质下白质区域。所有急性起病的患者均可见额外的慢性缺血性病变。急性起病的患者中，大多数（7例中的5例，71.42%）影像学表现为左侧受累。通过PubMed搜索，我们仅发现1例急性中风后舌肌张力障碍病例。另外还描述了3例慢性起病的中风后舌肌张力障碍病例；然而，这些病例均与口下颌或颅肌张力障碍相关。
基于脑部病变，我们的结果表明，所有急性梗死的舌肌张力障碍患者均有潜在的慢性梗死。总体而言，中风后包括肌张力障碍在内的舌部运动障碍中，左侧中风比右侧中风更为常见；然而，数据无统计学意义（p = 1）。所有患者均有构音障碍，只有1例有轻度舌肌无力，只有4例有面部肌无力。这表明在这些患者中，舌肌张力障碍是构音障碍的原因，而非肌无力。
