Spasmodic dysphonia associated with a left ventrolateral putaminal lesion.

A 34-year-old man presented with a 30-year history of spasmodic dysphonia. He developed a speech disturbance 1 month after a closed head injury due to a fall. Sighing, coughing, and crying were normal. He had a tremor of the right hand when he drew a vertical line. His out-stretched right hand had a minimal dystonic posture with occasional jerks of the fingers. T1-weighted axial brain MRI study showed a low signal intensity lesion at the putamen; coronal and axial T2-weighted MRI brain scans showed a high and low signal intensity lesion confined to the middle part of the ventrolateral putamen. Damage to the ventrolateral putamen may have caused abnormal voluntary control of the laryngeal muscles.