AMAarchives of neurology & psychiatry . ia, to which we wish to call especial attention, furtheremphasizes the postural or myostatic disturbance in the condition. But,whereas in most cases the kinetic disturbance obscures or overshadowsthe postural element, there are some in which the latter is plainlyevidetit and a few others in which it is dominant to such an extent that * From the Neurological Service of the Montefiore Hospital, New York. * Read at the Forty-Eighth .Annual Meeting of the American NeurologicalAssociation, Washington, D. C, May, 1922. IVECHSLER-BROCK—DVSTOXIA MUSCULORUM 539 o
AMAarchives of neurology & psychiatry . ia, to which we wish to call especial attention, furtheremphasizes the postural or myostatic disturbance in the condition. But,whereas in most cases the kinetic disturbance obscures or overshadowsthe postural element, there are some in which the latter is plainlyevidetit and a few others in which it is dominant to such an extent that * From the Neurological Service of the Montefiore Hospital, New York. * Read at the Forty-Eighth .Annual Meeting of the American NeurologicalAssociation, Washington, D. C, May, 1922. IVECHSLER-BROCK—DVSTOXIA MUSCULORUM 539 one begins to doubt whether the pictures are part of the same is our conviction that they are. The following case reports andtheir discussion will illustrate these points. REPORT OF CASES Case 1.—A case of dystonia musculorum deformans of the kinetic typebeginning in the right hand and, up to the present, involving the musculatureof both upper cxtroniiics, neck and head, liith a fragment of decerebraterigidity Fig. 1.—A case of dystonia illustrating segmental involvement and a fragmentof decerebrate rigidity limited to the right upper extremity. History.—B. M., a boy, aged 15 years, born in the United States, a Jew ofRussian parentage, about three and one-half years ago (1918) noticed difficultyin using his right hand, especially in writing. Soon after it was observedthat his left upper extremity was held in a peculiar position, namely, flexed atthe shoulder and elbow and adducted. About eighteen months after the onset,the patients head and body began to bend over to the left side. During thecourse of his illness there gradually developed peculiar defensive movementsof his left upper extremity, uncontrollable movements of the head and turn-ing movements of his body. 540 ARCnilES OF NEUROLOGY AXD PSYCHIATRY Physical Examination.—The gait was normal. There was a marked invol-untary torsion spasm involving the musculature of the head, neck, chest a
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