Cervical dystonia following peripheral trauma

Abstract

Post-traumatic cervical dystonia as a diagnostic entity remains a subject of debate. Patients with cervical dystonia (CD) were asked to identify any significant illness prior to the onset of their CD. Sixteen patients of 95 respondents reported a history of injury in the four-week period prior to onset of their dystonia. A retrospective study of the clinical characteristics of the 16 patients with early post-traumatic CD (CD-PT) in comparison with the 52 patients reporting no antecedent trauma (CD-NT) was performed. In this comparison the CD-PT group had a significantly increased frequency of laterocollis, significantly more reported pain and more reported depression. Non-significant trends were noted for less responsiveness to botulinum toxin and less use of gestes antagonistes in the CD-PT group. There were no group differences in the presence of a family history of dystonia. Eleven of the CD-PT group had been or were currently involved in litigation. A sub-group of seven CD-PT patients had laterocollis, six of whom conformed to a clinical pattern of persistent non-spasmodic laterocollis with marked pain; all seven had been involved in litigation. This form of CD-PT is a distinct clinical entity and has an onset within hours or a few days of the trauma. In contrast, no significant differences were noted between patients with CD-NT and the eight patients with later onset of CD between 4 weeks and one year after peripheral trauma.

An evaluation of the role of environmental factors in the disease penetrance of cervical dystonia

“…The European Transport Safety Council states that soft tissue neck injury (‘whiplash’) accounts for 65% of all injuries to persons in road traffic 17. That neck injury is a cause of secondary (post-traumatic) cervical dystonia is well recognised,18 but certain features differentiate it from idiopathic or primary dystonia 19. In our study, all cases had typical, sporadic isolated adult-onset cervical dystonia and did not have features of post-traumatic dystonia.…”

Retrocollis: Classification, Clinical Phenotype, Treatment Outcomes and Risk Factors

“…We also report a high frequency of trauma-associated RC. The association between CD and trauma, although debated by some [13], has been reported by several authors [14,15,16]. Unfortunately, there was not enough information available (mainly the exact interval between trauma and development of RC) to fully characterize posttraumatic dystonia in our cohort [17].…”

Sirolimus versus paclitaxel coronary stents in clinical practice

“…The geste movement must have a typical appearance before it can be used as a criterion to support the diagnosis: alleviation of dystonia occurs immediately and affects both tonic and phasic components. It has been observed that gestes do not improve nondystonic essential head tremor,33 are uncommon in early post‐traumatic dystonia34 and have atypical phenomenology in patients with psychogenic movement disorders 35…”