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July 1, 1939


Author Affiliations

Professor of Neurology, University of Illinois College of Medicine; Attending Neurologist, Cook County Hospital CHICAGO

From the Department of Neurology and Neurological Surgery, University of Illinois College of Medicine, and the Cook County Hospital.

JAMA. 1939;113(1):12-14. doi:10.1001/jama.1939.02800260014003

Dystonia musculorum deformans is characterized by excessive, involuntary, uncontrollable movements, some of which are choreiform and others athetoid, cerebellarlike or parkinsonian. It is a purely motor disturbance due, as Oppenheim1 emphasized, to a combination of motor restlessness with muscular hypertonia and hypotonia. The clinical picture may for a long time be dominated by disturbances of posture and gait (the myostatic phase of Wechsler and Brock2) before muscular restlessness becomes evident. Such cases do not even suggest dystonia and therefore are usually labeled hysteria, chorea, athetosis or some other form of muscular restlessness. Because dystonia resembles some other clinical manifestations, there is a tendency to discard it as a clinical entity.

According to others, dystonia not only is a clinical entity but exhibits definite pathologic changes in some basal ganglions—caudate nucleus and putamen (corpus striatum). Neither of the foregoing views is correct, for, while dystonia is unquestionably a definite