Dystonic posturing (DP) is one of the most reliable lateralizing symptoms f
or mesial temporal lobe epilepsy, although the mechanism remains unclear. W
e demonstrated a hyperperfusion area in the right putamen on subtracted pos
tictal SPECT by using the automatic registration technique in one patient w
ith ictal DP of the left hand. The putamen may play a key role in DP, simil
ar to other diseases with dystonia.