We report a 67-year-old @entity101 right-handed @entity1 who developed severe @entity158 and @entity3519 in her left upper and lower extremity after a @entity1188 . She was well until 9 months prior to the present admission to our hospital, when she had an acute onset of left @entity1269 which turned out to have been caused by a thalamic @entity1188 . Her @entity1269 showed nearly complete recovery during the next four months. She noted an onset of severe spontaneous @entity158 and difficulty in using her left hand four months prior to the present admission. Neurologic examination on admission revealed an alert and well oriented Japanese @entity1 . Cranial nerves were intact. Although she did not have weakness, her left hand showed thalamic posture, and upon standing, she showed a @entity3520 in which her left forearm took pronation and flexion at the elbow joint and her left lower extremity took extension in the knee joint and planter flexion in the ankle joint. Her @entity3520 increased during walking and disappeared in the supine position. She complained of severe spontaneous @entity158 in her left extremities. Position sense was diminished in her left leg. However other sensations were intact. She had slight ataxia on the left side. Deep tendon reflexes were symmetric, but the planter response was extensor on the left side. MRI revealed a small lacunar @entity1188 involving the right posterolateral thalamic region. EMG with surface electrodes revealed non-reciprocal tonic discharges in the left biceps brachii and forearm flexor and extensor muscles. She responded poorly to various medications. Only @entity20286 showed partial alleviation of her @entity158 . We thought her @entity158 might be caused by @entity3520 of the skeletal muscles, at least in part. We injected 25 IU of botulinus toxin as a total dose into her biceps brachii, triceps brachii, and wrist flexor muscles. A few days after the injection, her @entity3520 began to show marked improvement; as her @entity3519 improved, her @entity158 also showed marked improvement. This @entity1 appeared to represent a case of @entity3519 . Her @entity158 was initially thought to be the @entity158 . However, as her @entity158 disappeared with improvement of her @entity3519 , her @entity158 is most likely to have been caused by the @entity121 . Botulinus toxin treatment appears to be useful for post-hemiplegic painful @entity3519 .

[A case of post-hemiplegic painful XXXX following @entity1188 with good response to botulinus toxin].

@entity1 :: ('9606', 'Species') :: ['woman', 'patient'] @entity3520 :: ('MESH:D020821', 'Disease') :: ['dystonic posture', 'dystonic contraction'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertensive'] @entity1269 :: ('MESH:D010291', 'Disease') :: ['hemiparesis'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['thalamic infarction', 'infarct'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'pain and dystonic posture', 'thalamic pain', 'pain and tingling sensation'] @entity3519 :: ('MESH:D004421', 'Disease') :: ['post-hemiplegic dystonia', 'dystonia'] @entity121 :: ('MESH:D009135', 'Disease') :: ['dystonic muscle contraction'] @entity20286 :: ('MESH:D014282', 'Chemical') :: ['trihexyphenidyl']
@entity3519 :: (MESH:D004421,Disease) :: ['dystonia']
