(Pseudo)hemidystonia associated with anti‐glutamic acid decarboxylase antibodies – a case report

Kenda, J.; Kojović, Maja; Graus, Francesc; Kramberger, Milica G.

doi:10.1111/ene.12700

Cited by 4 publications

(3 citation statements)

References 6 publications

(7 reference statements)

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“…However, symptoms may be confined to one limb only, as in stiff limb syndrome, mimicking limb dystonia (Fig. 3, Video 5), or may even present in hemidistribution, resembling hemidystonia [35].…”

Section: Disorders Of the Motor Pathwaysmentioning

confidence: 99%

Pseudodystonia: A new perspective on an old phenomenon

Berlot

Bhatia

Kojović

2019

Parkinsonism & Related Disorders

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Pseudodystonia represents a wide range of conditions that mimic dystonia, including disorders of the peripheral nervous system, spinal cord, brainstem, thalamus, cortex and non-neurological conditions such as musculoskeletal diseases. Here, we propose a definition of pseudodystonia and suggest a classification based on underlying pathophysiological mechanisms. We describe phenomenology of different forms of pseudodystonia and point to distinctions between dystonia and pseudodystonia as well as challenging issues that may arise in clinical practice. The term pseudodystonia can be used to describe abnormal postures, repetitive movements or both, in which results of clinical, imaging, laboratory or electrophysiological investigations provide definite explanation of symptoms which is not compatible with dystonia. Pseudodystonia can be classified into non-neurological disorders of the musculoskeletal system, disorders of sensory pathways, disorders of motor pathways and compensatory postures in other neurological diseases. Presence of associated neurological findings in the affected body part is the key towards diagnosis of pseudodystonia. Additional supporting features are the presence of fixed postures, the absence of sensory trick, acute mode of onset and severe pain. Worsening on eye closure, traditionally considered typical for pseudodystonia, is not always present and can also appear in dystonia. It is challenging to separate dystonia and pseudodystonia in patients with thalamic lesions or corticobasal syndrome, where abnormal postures coexist with sensory loss. Many cases of pseudodystonia are treatable. Therefore, it is essential to consider pseudodystonia in a differential diagnosis of abnormal postures until a detailed neurological examination rules it out.

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Section: Disorders Of the Motor Pathwaysmentioning

confidence: 99%

Pseudodystonia: A new perspective on an old phenomenon

Berlot

Bhatia

Kojović

2019

Parkinsonism & Related Disorders

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“…Patients respond better to early initiation of immunotherapy rather than anticonvulsant monotherapy, though both are used in combined treatment. 23 Dystonia has also been reported uncommonly in association with GAD65 antibodies, 66,67 GlyR antibodies, 68 CRMP-5 antibodies, 45 antiphospholipid antibodies (often in association with parkinsonism), 69,70 and in Sjögren's syndrome. 71,72…”

Section: Dystoniamentioning

confidence: 99%

Autoimmune Movement Disorders

Fearon

O’Toole

2018

Semin Neurol

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Autoimmune movement disorders are rare but potentially treatable entities. They can present with an excess or paucity of movement and may have other associated neurological symptoms. These disorders were originally recognized by their classic clinical presentations and the cancers associated with them. Recent emphasis has been targeted on associated, and sometimes causative, antibodies. Although some disorders have stereotypical presentations, the spectrum of abnormalities reported in association with antibodies is widening. Determining whether antibodies are incidental or pathogenic and, hence, foregoing or commencing immunotherapy treatment can be challenging for practicing neurologists. Physicians often have to make the decision to empirically treat patients while awaiting test results. Due to the lack of randomized controlled trials, the ideal immunotherapy treatments and regimens are unknown. Patients with intracellularly targeted antibodies tend to fare less well, while those with extracellularly targeted antibody disorders often respond to treatments reducing antibody production. This review aims to summarize reported adult-onset autoimmune movement disorders to date, and to provide a template for the workup and treatment of suspected disorders. Rarer antibodies that are not yet fully characterized, or reported in a few cases only, will not be covered in detail as these are not likely to be readily commercially available. Childhood disorders will be only be mentioned briefly in the discussion, as there is a separate article in this issue on autoimmune neurologic diseases in children.

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“…Although each is non-specific, it has been proposed that, when used in combination and together with imaging, the specificity for detecting early PD may be increased significantly. Dystonia and other movement disorders are now attracting increasing attention in terms of treatment, particularly with non-medical forms including deep brain stimulation [118][119][120][121][122][123][124][125][126][127][128][129][130][131][132][133].…”

mentioning

confidence: 99%

Advances in neurological research and practice

Schapira¹

2016

Euro J of Neurology

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(Pseudo)hemidystonia associated with anti‐glutamic acid decarboxylase antibodies – a case report

Cited by 4 publications

References 6 publications

Pseudodystonia: A new perspective on an old phenomenon

Pseudodystonia: A new perspective on an old phenomenon

Autoimmune Movement Disorders

Advances in neurological research and practice

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