[P3-75] A pediatric case showed characteristic involuntary movement caused by brain tumor in basal ganglia
The patient was an 8 years old boy who had no past history. He visited the other hospital due to having difficulties opening his left hand and fingers smoothly for 1 month. Initially, he was suspected trigger fingers but the orthopedist denied it. He was referred to our hospital because he was suspected Paroxysmal Kinesigenic Dyskinesia (PKD). He was afebrile and his consciousness was lucid at the first visit. He kept his left hand grasping and he could not open his left hand with conscious. Then, he could not hold something with his left hand during the symptom. Furthermore, this symptom sometimes induced an abnormal posture with his left arm extension and pronation. A mild weakness was observed with his left hand. No spasticity or myotonia were seen. This involuntary movement occurred intermittently and continued for a couple of hours, but did not last continuously. It often happened during the day time to the evening, but it was not seen in his sleep. It was not induced with any intention or sound. This symptom was regarded as focal dystonia and we suspected movement disorder, such as PKD or basal ganglia disorder. The other causes, neuropathy or epilepsy had been denied in advance. After all, the brain MRI revealed a mass lesion in right caudate nucleus. Then he was diagnosed as a brain tumor in basal ganglia. It is a rare pediatric case of brain tumor who shows focal dystonia as an initial symptom.