Dystonic movement of the left upper limb in a case of the right pontine hemorrhage

: We report a 69-year-old woman who presented with dystonic movement in the left upper limb. She also had left hemiparesis and sensory disturbance in the right face and the left half of the body, pseudoathetosis in the left hand, and hotness, swelling, and lead-pipe rigidity in the left upper limb. The dystonic movement was presented mainly in the proximal part of the left upper limb, and was induced by voluntary movements; for example, when she was ordered to shake hands, the left shoulder always abducted with the flexion of the left elbow. Brain MRI showed a fresh hemorrhage in the dorsal part of the right middle pons including the base and the tegmentum, old infarctions in the right postero-lateral thalamus, putamen, and right parietal lobe. The dystonic movement persisted for 2 weeks, and hotness and swelling in the left upper limb lasted for 2 months, while the rigidity and pseudoathetosis persisted for 7 months or more despite medication.