Case Report
Challenges in Diagnosing and Managing Delayed Onset Paroxysmal Generalized Dystonias Associated with Bilateral Thalamic Hemorrhagic Venous Infarction Due to Extensive Cerebral Venous Thrombosis (CVT) in a 15-Year-Old Adolescent: A Case Study
Issue:
Volume 13, Issue 1, March 2025
Pages:
1-6
Received:
7 December 2024
Accepted:
23 December 2024
Published:
9 January 2025
DOI:
10.11648/j.ajpn.20251301.11
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Views:
Abstract: Cerebral venous thrombosis (CVT) constitutes less than 1% of stroke occurrences. The prevalence of abnormal movements following a stroke remains unclear, with movement disorders observed after a stroke ranging from 13 to 22% of secondary disorders. Nonetheless, these disorders are present in only 1% to 4% of stroke cases, with dystonias being the most commonly linked abnormalities in ischemic strokes. The lesions that lead to dystonias primarily affect the basal ganglia, thalamus, brainstem, cerebellum, and specific cortical regions. Dystonias make up about 30% of abnormal movements observed after a thalamic stroke, with the lesions typically being unilateral. This research discusses instances of delayed paroxysmal dystonias related to bilateral hemorrhagic infarction in the thalamus of an adolescent with cerebral venous thrombosis. A 15-year-old adolescent was admitted due to a rapidly developing disturbance of consciousness. Upon arrival, he exhibited a non-massive left hemicorporal pyramidal syndrome, left-sided tonic seizures, and a state of confusion. Magnetic resonance imaging revealed a bilateral thalamic hemorrhagic focus and cerebral venous thrombosis. Anticoagulant therapy was initiated, and the clinical progression during the acute phase was satisfactory. Ten days later, the patient displayed generalized but asymmetrical paroxysmal dystonias, predominantly affecting the left hemibody. This case presented diagnostic challenges, as the abnormal dystonic movements were linked to focal tonic seizures, alongside management issues, given that most antidystonic medications are sedative in nature, complicating treatment due to the pre-existing disturbance of consciousness. Nevertheless, the patient's condition improved under cautious administration of anticholinergic agents and GABAergic agonists.
Abstract: Cerebral venous thrombosis (CVT) constitutes less than 1% of stroke occurrences. The prevalence of abnormal movements following a stroke remains unclear, with movement disorders observed after a stroke ranging from 13 to 22% of secondary disorders. Nonetheless, these disorders are present in only 1% to 4% of stroke cases, with dystonias being the m...
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,
Abel Christian Tanoh
