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Arq Neuropsiquiatr 2012;70(8):637-644 640 We also highlight the fact that this unusual presentation of dystonia is almost indistinguishable from essential BSM, except by the non-involvement of the orbicularis oculi muscles. To best of our knowledge, this is the first report of sole frontalis, corrugator and procerus dystonia. Recently, Hirota et al.5 reported two cases of dystonic frowning. The first patient presented involuntary frowning and grimacing as the sole symptom, with no eyelid involvement. The second had typical symptoms of BSM only in the early phase of the disease, later the pattern of contractions changed and involuntary frowning and grimacing predominated. As most focal dystonias, these cases also presented excellent response to the use of botulinum toxin type A.

Intensive care management in brain contusion with microdialysis technique