Journal of Movement Disorders

Case Report

Hot Cross Bun Sign Following Bilateral Pontine Infarction: A Case Report: Sook Young Roh, Hyun-soon Jang, Yoon Hee Kim; J Mov Disord. 2013;6(2):37-39. Published online October 30, 2013; DOI: https://doi.org/10.14802/jmd.13009

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The hot cross bun sign is characterized by cruciform T2 signal hyperintensity in the pons and has been reported to be a specific but not pathognomic for multiple system atrophy. It reflects degeneration of pontine neurons and transverse pontocerebellar fibers, regardless of the underlying pathogenic process. Here, we report a case of hot cross bun sign following bilateral pontine infarction due to Wallerian degeneration of the pontocerebellar fibers.

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A case of bilateral middle cerebellar peduncle infarction with hot cross bun sign
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Hot Cross Bun Sign in Bilateral Middle Cerebellar Peduncle Infarction
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Stroke.2023;[Epub] CrossRef
“Hot Cross Bun” Sign in a Patient with Glutamic Acid Decarboxylase 65-KDa Isoform Associated Cerebellar Ataxia: Case Report and Review of the Literature
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The Cerebellum.2023;[Epub] CrossRef
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Movement Disorders Clinical Practice.2022; 9(8): 1105. CrossRef
Multiple system atrophy mimicry in MRI: Watch out for paraneoplastic rhombencephalitis
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Journal of Clinical Neuroscience.2020; 76: 238. CrossRef
Various Diseases and Clinical Heterogeneity Are Associated With “Hot Cross Bun”
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Frontiers in Aging Neuroscience.2020;[Epub] CrossRef
The ‘Hot Cross Bun’ Sign Is Not Always Multiple System Atrophy: Etiologies of 11 Cases
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Journal of Movement Disorders.2019; 12(1): 27. CrossRef
Role of Magnetic Resonance Imaging in the Diagnosis of Multiple System Atrophy
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Paraneoplastic neurological syndrome due to burned-out testicular tumor showing hot cross-bun sign
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Review Article

Secondary Dystonia-Clinical Clues and Syndromic Associations: Susanne A Schneider, Kailash P Bhatia; J Mov Disord. 2009;2(2):58-63.; DOI: https://doi.org/10.14802/jmd.09016

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Abstract PDF

Background:

Dystonia is a hyperkinetic movement disorder defined by involuntary sustained muscle spasms and unusual postures. Etiologically, dystonic syndromes can be broadly divided into primary and secondary forms, dystonia-plus syndromes and heredodegenerative forms. In particular, diagnosis of secondary dystonic syndromes can be challenging in view of the variety of causes.

Purpose:

The purpose of this article is to highlight some clinical clues and syndromic associations as well as investigational findings which may be helpful in the approach to a patient with suspected secondary dystonia.

Methods:

We outline characteristic clinical and neuroimaging findings which may be directive in the diagnostic process of dystonia patients and facilitate making the correct diagnosis, thus allowing initiating the best treatment.

Results:

Secondary causes of dystonia include, among others, strategic brain lesions of various origins, metabolic disease, neurodegenerative conditions, and previous exposure to drugs or toxins. Presence of clinical signs including prominent oromandibular involvement, eye movement disorders, retinitis pigmentosa, deafness, peripheral neuropathy, parkinsonism or progressive dementia should alert the clinician to consider a secondary cause. Strategic lesions within the basal ganglia, but also within the brainstem, cerebellum or cortical areas may underlie dystonia and should thus be excluded.

Conclusions:

When thorough clinical examination reveals features atypical of primary dystonia, syndromic associations may help the clinician to narrow down the list of differential diagnosis. Directive investigations like neuroimaging may confirm the clinical suspicion.

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Journal of Veterinary Internal Medicine.2024; 38(1): 277. CrossRef
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Udit Saraf, Mitesh Chandarana, KP Divya, Syam Krishnan
Annals of Indian Academy of Neurology.2022; 25(1): 26. CrossRef
Oromandibular Dystonia: A Clinical Examination of 2,020 Cases
Laura M. Scorr, Stewart A. Factor, Sahyli Perez Parra, Rachel Kaye, Randal C. Paniello, Scott A. Norris, Joel S. Perlmutter, Tobias Bäumer, Tatiana Usnich, Brian D. Berman, Marie Mailly, Emmanuel Roze, Marie Vidailhet, Joseph Jankovic, Mark S. LeDoux, Ric
Frontiers in Neurology.2021;[Epub] CrossRef
Clinical characteristics and diagnostic clues to Neurometabolic causes of dystonia
Chun Seng Phua, Kishore Raj Kumar, Stanley Levy
Journal of the Neurological Sciences.2020; 419: 117167. CrossRef
Botulinum toxin A in the treatment of dystonia
Lenka Hvizdošová, Pavel Otruba, Martin Nevrlý, Petr Kaňovský
Neurologie pro praxi.2020; 21(1): 21. CrossRef
Sensory trick in upper limb dystonia
Sabino Dagostino, Tommaso Ercoli, Angelo F. Gigante, Roberta Pellicciari, Laura Fadda, Giovanni Defazio
Parkinsonism & Related Disorders.2019; 63: 221. CrossRef
Dystonia in Patients With Spinocerebellar Ataxia Type 2
Vladana Markovic, Natasa T. Dragasevic‐Miskovic, Iva Stankovic, Igor Petrovic, Marina Svetel, Vladimir S. Kostić
Movement Disorders Clinical Practice.2016; 3(3): 292. CrossRef
Drug-induced movement disorders
Dénes Zádori, Gábor Veres, Levente Szalárdy, Péter Klivényi, László Vécsei
Expert Opinion on Drug Safety.2015; 14(6): 877. CrossRef
Novel GNAL mutation with intra-familial clinical heterogeneity: Expanding the phenotype
Miryam Carecchio, Celeste Panteghini, Chiara Reale, Chiara Barzaghi, Valentina Monti, Luigi Romito, Francesco Sasanelli, Barbara Garavaglia
Parkinsonism & Related Disorders.2015;[Epub] CrossRef
A CASE SUPPORTING THE ROLE OF THE CEREBELLUM IN DYSTONIA
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Case Reports

Generalized Chorea Induced by an Unilateral Anterior Cerebral Artery Territorial Infarction: Jae Hong Chang, Woo-Keun Seo, Moon-Ho Park, Jong-Mun Lee, Do-Young Kwon, Seong-Beom Koh; J Mov Disord. 2009;2(1):37-39.; DOI: https://doi.org/10.14802/jmd.09009

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85 Download
3 Crossref

Abstract PDF

Generalized chorea caused by unilateral cerebral infarction has rarely been reported. A 58-year-old woman presented involuntary movement in her all extremities after acute cerebral infarction on her right anterior cerebral artery territory. The involuntary movements were diagnosed as generalized chorea. We didn’t find any cause of generalized chorea except the acute cerebral infarction. Here, we described the case of generalized chorea after unilateral cerebral infarction discussing the possible mechanisms.

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Cerebral infarction in centrum semiovale presenting with hemichorea: a case report and literature review
Jingjing Yi, Lingru Zhang, Tao Zhang, Jianfeng Li, Yifan Zhang, Meining Zhou
Frontiers in Neurology.2023;[Epub] CrossRef
Movement Disorders Associated With Cerebral Artery Stenosis: A Nationwide Study
Kye Won Park, Nari Choi, Eungseok Oh, Chul Hyoung Lyoo, Min Seok Baek, Han-Joon Kim, Dalla Yoo, Jee-Young Lee, Ji-Hyun Choi, Jae Hyeok Lee, Seong-Beom Koh, Young Hee Sung, Jin Whan Cho, Hui-Jun Yang, Jinse Park, Hae-Won Shin, Tae-Beom Ahn, Ho-Sung Ryu, So
Frontiers in Neurology.2022;[Epub] CrossRef
Acute Hemichorea as an Unusual Presentation of Internal Carotid Artery Stenosis
Dong Wook Kim, Youngchai Ko, Sang Hyun Jang, Soo Jin Yoon, Gun-Sei Oh, Soo Joo Lee, Dong Joo Yun
Journal of Movement Disorders.2013; 6(1): 17. CrossRef

Jaw Dystonia Induced by Speaking: Jong-Sam Baik, Jae-Hyeon Park, Jeong-Yeon Kim, Sang-Won Han; J Mov Disord. 2008;1(1):55-57.; DOI: https://doi.org/10.14802/jmd.08010

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82 Download
1 Crossref

Abstract PDF

We describe a 43-year-old housewife who presented with dysarthria suddenly because her masseter muscles contracted bilaterally, when she was speaking. Brain MRI showed focal signal change on midbrain. Jaw dystonia induced by speaking is very rare and we chose an anticholinergic medication, rather than botulinumtoxin injection. Her condition was markedly improved after medication. We suspected that her symptoms were related with focal lesion, so she had secondary jaw dystonia induced by speaking.

Citations

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Non-occupational task-specific masticatory dystonia
Sang-Won Yoo, In-Seok Park, Hyung-Eun Park, Joong-Seok Kim
Neurological Sciences.2015; 36(2): 339. CrossRef

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