Impaired modulation of intracortical inhibition in focal hand dystonia

Previous studies have shown that intracortical inhibition (ICI) plays an important role in shaping the output from primary motor cortex, and that ICI may be impaired in people with Focal Hand Dystonia (FHD). This study explored the muscle-specificity and temporal modulation of ICI during the performance of a phasic index finger flexion task. Eight control subjects and seven with FHD were asked to rest their dominant hand upon a computer mouse, and depress the mouse button using their index finger in time with a 1 Hz auditory metronome, while keeping the rest of their hand as relaxed as possible. Responses to single and paired-pulse transcranial magnetic stimulation were recorded from the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles while subjects were at rest and during 'on' and 'off' phases of the task. For control subjects during the movement (i). FDI motor evoked potential (MEP) amplitude and pretrigger EMG increased, and ICI decreased, as expected, and (ii). there was no significant facilitation of MEP amplitude or pretrigger EMG for APB, which was associated with a significant increase in ICI during the movement. This may have helped prevent the unwanted activation of this muscle. While FHD subjects demonstrated the same patterns of modulation of both MEP amplitude and pretrigger EMG for both FDI and APB, their levels of ICI were not modulated by task performance. This was despite no difference between subject groups in the level of ICI observed at rest. These findings suggest that FHD is associated with impaired modulation of ICI during performance of a precise manual task, which may contribute to a lack of specificity in the output from M1 and the development of dystonic symptoms.     

Angiolymphoid hyperplasia with eosinophilia in the hand: a case report

Angiolymphoid hyperplasia is an uncommon condition which may give rise to difficulty in diagnosis. The case described was originally regarded as Kaposi's sarcoma, but H.I.V. testing was negative. Excision of a further lesion established the diagnosis as angiolymphoid hyperplasia.     

Treatment of homocystinuria-related dystonia with deep brain stimulation: a case report

A 23-year-old woman with the medical history of homocystinuria that had been diagnosed at the age of 14 has been non-responsive to treatment. The patient presented with the symptoms of dysphonia, dysarthria and severe dystonia of the neck and left extremities. Blood and urine biochemistry revealed high levels of homocystine. Brain magnetic resonance imaging was normal with no detectable pathologies. Medical treatment strategies were used and repeated injections of botulinum toxin A were administered, but the symptoms showed no significant improvement. The patient was then operated, and deep brain stimulators targeting the bilateral globus pallidus internus were implanted. After the activation of the electrodes, dystonia symptoms showed a remarkable improvement. Good outcome was documented during the follow-up period of 7 months. To our best knowledge, this is the first reported case of homocystinuria-related dystonia symptoms that were successfully treated with deep brain stimulation.     

Multiple chondrosarcomas in a hand: A case report

In a patient with multiple enchondromas limited to the ring finger and the fifth ray of the left hand, four of the enchondromas underwent simultaneous malignant degeneration during a 7 year observation period. Roentgenograms showed the initial cortical expansion changing to cortical destruction and soft tissue invasion. Ray resection of the involved digits was performed with a good functional result.     

Perichondrial arthroplasty in the hand: a case report

A two-stage arthroplasty technique was used to treat an isolated fibrous ankylosis that developed in the index metacarpophalangeal joint of a 14-year-old boy after a rattlesnake bite. The first stage consisted of a minimal joint resection combined with rib perichondrial grafts to resurface the joint. The second stage, performed 5 months later, consisted of a capsulotomy and removal of a silicone membrane left within the joint to separate the grafts. Biopsy of the joint surfaces revealed the presence of hyaline-like cartilage. Nearly normal pain-free motion was restored. Follow-up now exceeds 30 months.     

Soft tissue sarcoidosis of the hand: a case report.

A tumour of the hand may be the first manifestation of systemic sarcoidosis. In our patient, this mass involved only the soft tissues; more commonly, there is bone involvement as well.     

Malignant chondroid syringoma of the hand: a case report.

We present a rare case of malignant chondroid syringoma of the hand in a 37-year-old man. Ray amputation with coverage by an island reverse flow forearm flap gave a good final result. There have been no signs of recurrence during a follow up of five years.     

Leiomyoma of the hand: a case report

We report a case of leiomyoma of the finger in the right hand of a 12-year-old boy: a rare site for localization and unusual for age. This is a benign tumor originating from non-striated muscle that is very uncommon in the hand. The uterus is considered the most common location for leiomyoma and when it occurs in the extremities, it is more common in the leg, ankle and foot. It usually occurs in the third and fourth decades of life and it is rarely diagnosed before surgery as the diagnosis can only be confirmed histologically.     

Giant lipoma of hand: a case report

Lipomas are one of the commonest benign soft tissue tumors but occurrence in hands is rare. They can cause mechanical dysfunction, pain and altered sensibility in hand. Complete resection may not be required.     

Chondrolipoma of the hand: a case report

The authors present the case of a chondrolipoma which was excised from the left hand's palm of an 83-year old woman. Chondrolipomas are rare neoplasms; their terminology and pathogenesis have been controversial in the past. Chondrolipoma in the hand does not seem to have been reported so far. The present case thus expands the spectrum of neoplasms known to arise at this anatomical site.     

手足多发性痛风结石1例

患者,男,23岁。因手足多发性皮下痛性结节8年,加重伴破溃1个月入院。患者8年前无明显诱因双手及双足部的多关节处出现结节样肿块,面积大小不等,且自觉患处肿块疼痛明显,曾在外院诊治,予口服别嘌醇片、秋水仙碱等药物治疗（具体剂量及用法不详）,疼痛感较前缓解,但结节样肿块未见消退。近1个月自觉双侧手足处肿块疼痛较前明显加重,     

Extramedullary plasmacytoma of the hand: a case report

Plasmacytoma commonly occurs as an interosseous lesion. The soft tissue variant of plasmacytoma has been found infrequently in the feet but not in the hands. We describe a 47-year-old man with extensive involvement of the flexor tendons by a plasmacytoma.     

Ewing's sarcoma of the hand: a case report

Ewing's sarcoma of the hand is rare. This tumor was first described in 1921, since then, only a few cases with hand involvement have been reported. We report a case of Ewing's sarcoma of the left hand, presenting as a swelling of the hand gradually enlarging over six months. Plain radiographs showed marked osteolysis of the second, third and fourth metacarpals. Histological confirmation was made following biopsy. Despite amputation and post-operative chemotherapy, death occurred two months later due marrow aplasia.     

A variant of mirror hand: a case report

We report a variant of mirror hand in a 3.5-year-old boy who presented with multiple fingers. The x-ray revealed an attempt at fusion of 2 hypoplastic radii, 1 ulna, and multiple fingers. The unique feature of this case is a broad radius with proximal notching suggesting failed incomplete duplication. The reasons for this duplication and duplication of the fingers appear to be different.