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Dystonia of the legs induced by walking or passive movement of the big toe in a patient with cerebellar ectopia and syringomyelia

University Department of Neurology, Institute of Psychiatry and King's College Hospital Medical School (Drs. Thompson, Day, Rothwell, and Marsden), Denmark Hill, London, UK; Quinta Clinica Neurologica, Dipartimento di Scienze Neurologiche (Dr. Berardelli), Universita di Roma "La Sapienza," viale dell' Universita 30 Roma, Italy; Department of Neurology (Dr. O'Brien), Guy's Hospital, London. UK.

A 45-year-old man with dystonia of the legs was found to have cerebellar ectopia and syringomyelia. Both walking and passive movements of the big toes evoked dystonic postures of the legs. Electrophysiologic studies suggested that the dystonic movements were reflex in origin. We propose that the cervical spinal cord lesion, involving propriospinal pathways, resulted in an abnormal response of spinal interneurons to peripheral stimuli.

Address correspondence and reprint requests to Dr. Marsden, University Department of Neurology, Institute of Psychiatry and King's College Hospital Medical School, Denmark Hill, London SE5. UK.

Supported by the Medical Research Council. J.C.R. was a Royal Society University Research Fellow.

Accepted for publication May 8, 1985.

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