Dystonia and Choreoathetosis in Multiple Sclerosis

Abstract

Involuntary movements related to basal ganglia structures are quite rare in multiple sclerosis (MS), with only a few cases of resting tremor, hemiballism, or choreoathetosis having been reported.¹A review of the literature has not disclosed any cases of MS in which dystonia was a major manifestation. <h3>Report of Cases.—</h3> Case 1.—A 35-year-old man was admitted with marked continual dystonic movements of his face, neck, and extremities. His muscles were hypertrophied from the constant motion, and he frequently assumed awkward postures in bed. Speech (other than "yes" and "no") was impossible because of oral facial dystonia. Eye movements, strength, and sensation were intact. He was hyperreflexic with a left-sided Babinski sign. His past history spanned 11 years, with intermittent neurological signs including anisocoria, nystagmus, bulbar weakness (requiring a tracheostomy on one occasion), long tract signs, and varying sensory changes (including a thoracic level on one admission). Laboratory data showed