SUMMARYEight cases of persistent dystonia appearing one to 14 years after non-progressive cerebral insults are described. Five were due to perinatal anoxia, one to trauma, and two to cerebral infarction. This phenomenon of delayed-onset dystonia has not been described previously, although review of earlier literature reveals several probable examples. Delayed-onset dystonia due to perinatal anoxia is an important diagnostic alternative to dystonia musculorum deformans for dystonia occurring in childhood.Abnormal involuntary movements may he caused by non-progressive cerebral insults. Choreic, athetoid and dystonic movements due to perinatal anoxia or kericterus,l and ballistic, choreic and athetoid movements due to cerebral infarction2 have been documented. In addition, abnormal involuntary movements have been reported after trauma, anoxia or carbon monoxide poisoning in the adult.3In general, the abnormal involuntary movements in such cases appear either (1) at the time the insult occurs, (2) when the acute neurologic deficit resolves, or (3) when the patient matures neurologically, as in the case of perinatal insults. In a study of the natural history of choreoathetoid cerebral palsy, Polanil found that of 56 patients, 39 had abnormal involuntary movements by the age of 21 years, and the other 17 had abnormal involuntary movements by the age of 3j years. These data are supported by the observations of Crothers and Paine5 who noted that the majority of patients with "extrapyramidal" cerebral palsies were first seen between the ages of 10 and 18 months because of abnormal motor development. As these children grew older, abnormal involuntary movements developed. Paine¢ serially evaluated children with perinatal brain injury and noted that of those who ultimately developed choreo-athetosis or dystonia, 92% showed visible chorea or athetosis by the age of three years. The abnormal move-

No abstract

No abstract

No abstract

No abstract