The lesions which produce dystonic symptoms are encountered in the brain stem, particularly in the basal ganglia. In an earlier study1 an attempt was made to compare the sites of lesions forming the basis of the various types of abnormal involuntary movements in nervous diseases. The lesions observed at autopsy in the cases in which dystonic symptoms were exhibited reported up to the time of publication of that report are shown in the figure. It is clear that one is far from being able to predict the exact site of the lesion from any given pattern of involuntary motor activity.
The present study, however, is concerned not so much with the site of the lesion as with the underlying pathologic process, since the peculiarity of the pathologic changes determines the type of onset and the course of the disease.
According to the fundamental investigations of C. and O. Vogt,
HERZ E. DYSTONIAIII. PATHOLOGY AND CONCLUSIONS. Arch NeurPsych. 1944;52(1):20-26. doi:10.1001/archneurpsyc.1944.02290310026002