Zusammenfassung
Dystone Syndrome als Ausdruck einer fokalen Hirnläsion sind selten, wobei der Tortikollis wiederum besonders selten auftritt. Wir berichten über eine Patientin mit symptomatischem Tortikollis bei Hypoparathyreoidismus. Im CCT zeigten sich rechts paraventrikulär sowie in den Stammganglien und dem Thalamus beidseits Kalkablagerungen. Dass es bei Hypoparathyreoidismus mit Hypokalzämie zu Stammganglienverkalkungen kommen kann, ist ein bekanntes Paradoxon. Die recht ausgeprägten und nicht auf das Pallidum begrenzten Verkalkungen sprechen in unserem Fall für einen kausalen Zusammenhang. Asymptomatische, „idiopathische” Stammganglienverkalkungen sind meist auf das Pallidum begrenzt. Wir empfehlen bei fokalen Dystonien die Bestimmung des Serumkalziums zum Ausschluss einer behandelbaren Störung des Kalziumstoffwechsels.
Abstract
Dystonic syndromes as a consequence of a focal brain lesion are rare. Symptomatic cervical dystonia occurs particularly rarely. We report a patient presenting with dystonic torticollis. Low serum calcium and further laboratory studies revealed hypoparathyroidism. Computed tomography scan of the brain demonstrated calcifications in the basal ganglia and thalamus bilaterally as well as in the paraventricular white matter. That hypoparathyroidism with hypocalcemia may be associated with calcifications of the basal ganglia is a known paradox. The basal ganglia calcifications exeeding the pallidum make a causal relationship between calcification and torticollis highly probable in our case. Asymptomatic „idiopathic” basal ganglia calcifications are usually limited in their distribuation to the pallidum. We advise investigation of the serum calcium in focal dystonias to exclude a treatable disorder of the calcium metabolism.
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Dr. Marion Gerlach
Neurologische Klinik · Klinikum Kassel GmbH
Mönchebergstraße 41 - 43
34125 Kassel
Email: gerlachmarion@web.de
