Cervical dystonia

Jankovic, Joseph; Leder, Stuart; Warner, Dhyanne; Schwartz, Kenneth S.

doi:10.1212/wnl.41.7.1088

Cited by 397 publications

(311 citation statements)

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“…This could explain why we found only one case of family history in the HT+ group. A previous report 2 showed that there was a higher frequency of dystonia and tremor in relatives of patients with dystonia. We found a higher prevalence of postural hand tremor in HT+ group.…”

Section: Methodsmentioning

confidence: 86%

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Head tremor in patients with cervical dystonia: different outcome?

Godeiro-Júnior

Felı́cio

Aguiar

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective:The association of cervical dystonia (CD) with other movement disorders have been already described, but data on clinical outcome regarding these patients are scant. The aim of this paper was to investigate whether patients with CD and head tremor (HT) would have a different outcome regarding to botulinum toxin type-A (BTX-A) treatment response and clinical and demographic parameters. Method: We retrospectively evaluated 118 medical charts of patients with CD and divided them into two groups: with (HT+) and without (HT-) head tremor. We compared the following clinical and demographic parameters: age at onset, disease duration, progression of symptoms, etiology, familial history, presence of hand tremor. We also analyzed the response to BTX-A according to Tsui score in both groups. Results: The occurrence of head tremor in our sample was of 38.2%. The occurrence of postural hand tremor in the patients from the HT+ group was higher than in the HT-one (p=0.015) and if we compare BTX-A response in each group, we observe that patients with HT present a better outcome in a setting of longer follow-up. In HT+ group, Tsui score pre treatment was 10 (6-12.5) and after follow-up was 8 (5.5-10.5); p<0.001. In HT-group there was no significant difference 9 (7-12) in pre treatment and after follow-up; p=0.07. Conclusion: According to our data it seems that head tremor may influence the clinical outcome or treatment response with BTX-A in patients with CD.Key WorDs: cervical dystonia, head tremor, botulinum toxin type-A, outcome. Tremor cefálico em pacientes com distonia cervical: evolução diferente?Resumo -Objetivo: A associação de distonia cervical (DC) com outros transtornos do movimento já foi descrita, mas há poucos dados quanto à evolução clínica destes pacientes. Avaliamos se os pacientes com DC e tremor cefálico (TC) apresentam características clínicas e demográficas, assim como a resposta ao tratamento com toxina botulínica tipo A, diferentes. Métodos: Analisamos retrospectivamente 118 prontuários de pacientes com DC e os dividimos em dois grupos: com (TC+) e sem (TC-) tremor cefálico. Comparamos os seguintes parâmetros clínicos e demográficos entre os grupos: idade de início, duração da doença, progressão de sintomas, etiologia, história familiar, presença de tremor em mãos. Também analisamos a resposta ao tratamento com toxina botulínica de acordo com escore Tsui em ambos os grupos. Resultados: A ocorrência de tremor cefálico em nosso grupo de pacientes foi 38,2%. A ocorrência de tremor postural nas mãos em pacientes TC+ foi maior (p=0,015) e se compararmos a resposta ao tratamento com toxina botulínica em cada grupo, observamos que os pacientes com TC têm melhor evolução em uma situação de seguimento mais prolongado. No grupo TC+, o escore Tsui pré-tratamento foi 10 (6-12,5) e após o período de "follow-up" foi 8 (5,5-10,5); p<0,001. No grupo TC-, não houve diferença significante: 9 (7-12) no pré-tratamento e após período de "follow-up"; p=0,07. Conclusão: Nossos dados apontam que o tremor cefál...

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Section: Methodsmentioning

confidence: 86%

“…It is often associated with other movement disorders, particularly tremor. some consider that essential tremor and idiopathic dystonia may be genetically linked 2 . The mechanism underlying CD and head tremor is unknown, but its association is frequent as assessed with other studies 3 .…”

mentioning

confidence: 99%

Head tremor in patients with cervical dystonia: different outcome?

Godeiro-Júnior

Felı́cio

Aguiar

et al. 2008

Arq. Neuro-Psiquiatr.

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“…The relationship between scoliosis and dystonia seems to be reinforced by their association in human clinic. Patients with idiopathic cervical dystonia, a most frequent focal dystonia, develop scoliosis in 39% of cases [37]. Furthermore, scoliosis develops in late childhood or early puberty more frequently among patients with cervical dystonia [38].…”

Section: Discussionmentioning

confidence: 99%

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

et al. 2009

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The aetiology of idiopathic scoliosis (IS) remains unknown; however, there is a growing body of evidence suggesting that the spine deformity could be the expression of a subclinical nervous system disorder. A defective sensory input or an anomalous sensorimotor integration may lead to an abnormal postural tone and therefore the development of a spine deformity. Inhibition of the motor cortico-cortical excitability is abnormal in dystonia. Therefore, the study of cortico-cortical inhibition may shed some insight into the dystonia hypothesis regarding the pathophysiology of IS. Paired pulse transcranial magnetic stimulation was used to study corticocortical inhibition and facilitation in nine adolescents with IS, five teenagers with congenital scoliosis (CS) and eight healthy age-matched controls. The effect of a previous conditioning stimulus (80% intensity of resting motor threshold) on the amplitude of the motor-evoked potential induced by the test stimulus (120% of resting motor threshold) was examined at various interstimulus intervals (ISIs) in both abductor pollicis brevis muscles. The results of healthy adolescents and those with CS showed a marked inhibitory effect of the conditioning stimulus on the response to the test stimulus at interstimulus intervals shorter than 6 ms. These findings do not differ from those reported for normal adults. However, children with IS revealed an abnormally reduced cortico-cortical inhibition at the short ISIs. Cortico-cortical inhibition was practically normal on the side of the scoliotic convexity while it was significantly reduced on the side of the scoliotic concavity. In conclusion, these findings support the hypothesis that a dystonic dysfunction underlies in IS. Asymmetrical cortical hyperexcitability may play an important role in the pathogenesis of IS and represents an objective neurophysiological finding that could be used clinically.

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“…In these patients pain is frequent and prominent, occurring in 66-85%. 4,5 Many patients have a limited range of neck motion. 4 Up to a third develop premature spondylosis 6,7 with accompanying radiculopathy and rarely myelopathy.…”

Section: Introductionmentioning

confidence: 99%

Compensatory head posture and neck problems: is there an association? A cohort study of nystagmus patients

Morris

Smith

Elphick

et al. 2008

Eye

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Purpose The aims of this study were twofold: to investigate if a compensatory head posture due to nystagmus causes long-term neck problems or adversely effects quality of life and to survey ophthalmologists on their opinions and management of these patients. Methods A case-controlled study was carried out to assess the range of neck movements in patients with compensatory head posture due to congenital nystagmus. Exclusion criteria included known neck problems, vertebrobasilar insufficiency, and age less than 16 years. Neck movements were assessed using an inclinometer. Quality of life and disability was assessed using the American Academy of Orthopaedic Surgeons' Cervical Spine Questionnaire. One hundred and fifty consultant ophthalmologists throughout the United Kingdom were surveyed via a postal questionnaire. Results The range of motion in these patients (n ¼ 20) was limited when compared to matched controls especially for lateral flexion (P ¼ 0.001) and extension (P ¼ 0.003). However, despite limited movement, patients did not perceive a disability and there was no adverse effect on quality of life. In all 55% of ophthalmologists believed compensatory head posture due to nystagmus leads to long-term neck problems. About 46% had personal experience of patients with long-term neck problems due to nystagmus. Eighty-four per cent were influenced in their decision to operate by the presence of a head posture. Conclusions Significant restriction in neck movements exists in nystagmus patients with compensatory head posture, although this does not appear to adversely affect quality of life.

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Cervical dystonia

Cited by 397 publications

References 1 publication

Head tremor in patients with cervical dystonia: different outcome?

Head tremor in patients with cervical dystonia: different outcome?

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

Compensatory head posture and neck problems: is there an association? A cohort study of nystagmus patients

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