Head Tremor in Cervical Dystonia

Pal, Pramod; Samii, Ali; Schulzer, Michael; Mak, Edwin; Tsui, Joseph

doi:10.1017/s0317167100052240

Cited by 77 publications

(58 citation statements)

References 16 publications

(7 reference statements)

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“…This wide variability between studies probably reflects methodological factors, including small patient samples,5–7 13 14 focus on one type of focal dystonia alone,5 6 8–10 12–14 medical chart review rather than clinical examination to identify tremor,8 14 and choice of diagnostic criteria 5–14. Unlike other studies, we examined a large, representative sample of Italian patients with PAOD.…”

Section: Discussionmentioning

confidence: 99%

Tremor in primary adult-onset dystonia: prevalence and associated clinical features

Defazio

Gigante

Abbruzzese

et al. 2012

Journal of Neurology, Neurosurgery & Psychiatry

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Tremor is a relatively common feature occurring in about 17% of patients with primary late-onset dystonia. The association between tremor and dystonia spread suggests that this form of tremor may be a dystonic manifestation. Similarities in phenotypic features of DT and TAWD predominated over differences, suggesting that the two forms of tremor may be manifestations of the same disease. Differences in gender and body distribution of tremor between patients with dystonia and tremor and those of patients with essential tremor also suggest that tremor in dystonia and essential tremor are different entities.

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Section: Discussionmentioning

confidence: 99%

Tremor in primary adult-onset dystonia: prevalence and associated clinical features

Defazio

Gigante

Abbruzzese

et al. 2012

Journal of Neurology, Neurosurgery & Psychiatry

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“…Head tremor in the context of cervical dystonia is the most common form of DT, found in up to 68% of these patients in one survey 5. In one Brazilian cross-sectional study, it was estimated that approximately 20% of patients with dystonia have postural tremor of the upper limbs (ie, TAD) 6.…”

Section: Introductionmentioning

confidence: 99%

The treatment of dystonic tremor: a systematic review

Fasano

Bove

Lang

2013

Journal of Neurology, Neurosurgery & Psychiatry

115

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Tremor is one of the clinical manifestations of dystonia; however, there are no specific therapeutic trials evaluating the efficacy of treatments for dystonic tremor (DT), tremor associated with dystonia or primary writing tremor (PWT). We systematically reviewed the literature available up to July 2013 on the treatment of these tremors and retrieved the data of 487 patients published in 43 papers detailing the effects of given interventions on tremor severity. Treatment outcome was highly variable, depending on the specific type of intervention and tremor distribution. No specifically designed studies were available for the treatment of tremor associated with dystonia. As for the other tremors, drug efficacy was generally disappointing and a moderate effect was only found with anticholinergics, tetrabenazine, clonazepam, β-blockers and primidone; levodopa was only efficacious on tremor due to dopa-responsive dystonia. The largest amount of data was available for botulinum toxin injections, which provided a marked improvement, particularly for the management of axial tremors (head or vocal cords). In refractory DTs, deep brain stimulation of several targets was attempted. Deep brain stimulation of globus pallidus internus, thalamus or subthalamic area led to a marked improvement of dystonic axial or appendicular tremors in most cases refractory to other treatments. Few other non-invasive treatments, for example, orthotic device in PWT, have been used with anecdotal success. In conclusion, considering the lack of good-quality studies, future randomised controlled trials are needed. In absence of evidence-based guidelines, we propose an algorithm for the treatment of DT based on currently available data.

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“…Application of BoTx has been successful in both essential and dystonic head tremor [6,25,38]. Palatal tremor as well as voice tremor and chin tremor respond favorably to this treatment.…”

Section: ■ Further Indicationsmentioning

confidence: 99%

Botulinum toxin in multiple sclerosis

Jost

2006

J Neurol

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Local administration of botulinum toxin (BoTx) inhibits presynaptic acetylcholine release. All cholinergically innervated muscles and glands can be paralyzed accordingly. Studies on the application of BoTx in multiple sclerosis have shown good results for focal spasticity, in particular, of the extremities. The first promising data were published on bladder disorders, especially with regard to detrusor sphincter dyssynergia and detrusor hyperreflexia. Hyperhidrosis, hypersalivation and proctologic symptoms might be other areas of application. Approval, however, has been greatly restricted which limits the therapeutic range of use.

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Head Tremor in Cervical Dystonia

Cited by 77 publications

References 16 publications

Tremor in primary adult-onset dystonia: prevalence and associated clinical features

Tremor in primary adult-onset dystonia: prevalence and associated clinical features

The treatment of dystonic tremor: a systematic review

Botulinum toxin in multiple sclerosis

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