Focal dystonia after chemotherapy: a case series

Dystonia is a rare neurologic disorder of thebasal ganglia presenting with involuntary twisting or turningspasm of muscles. Movements localized to the face,eyes, or neck generally present during late adulthood.Cranial dystonia is usually idiopathic but may becaused by trauma or medications. Of 148 patientswith focal dystonia referred to Indiana University overfour years, four women had the onset offace and neck symptoms eight days to 34months after completing treatment with chemotherapy alone orcombined with radiation therapy. Two patients were treatedwith 5-FU, one received doxorubicin and one wastreated with both. Both drugs have been associatedwith transient parkinsonism, but no chemotherapeutic medications havebeen reported to cause dystonia. Three patients remainfree of demonstrable malignancy. A possible association ofchemotherapy and focal dystonia has not been previouslydescribed.