Speech-Induced Cervical Dystonia

Speech-Induced Task-Specific Cranio-Cervical Tardive Dystonia: An Unusual Phenomenology

“…To the best of our knowledge, only two cases of speech-induced cervical TSD have been reported so far in the literature. 1,2 Both cases only had cervical dystonia, unlike our case who also had cranial involvement. The etiology was probably idiopathic in both cases, as the workup for secondary causes was negative, and there was no history of prior drug intake.…”

“…Speech inducibility may suggest abnormal activation and dystonic overflow to the surrounding facial, lingual, labial, mandibular and cervical musculature, with laryngeal activation due to abnormal surrounding inhibition in the cortex. 2 In conclusion, even though speech-induced dystonia commonly involves craniofacial muscles, it can rarely lead to a taskspecific cranio-cervical dystonia. Tardive dystonia should be considered while evaluating the etiology of such cases.…”

“…Speech-induced dystonia often involves laryngeal and cranial muscles, with a speech-induced cervical TSD very rarely reported. 1,2 This report describes an unusual case of a speech-induced segmental TSD affecting the cranio-cervical area and probably having a drug-induced etiology.…”

“…Speech-induced dystonia is a rare form of TSD, usually causing oral, lingual, labial or mandibular dystonia, in isolation or in various combinations. 2 This form can rarely be contextual, e.g., while praying, auctioneering or reciting mantras. 7 It may remain task specific or, over time, can be triggered by other tasks.…”

Positional Torticollis While Lying on Side

“…As a rule, symptoms of dystonia diminish or disappear in a recumbent position and are exacerbated when upright1, 2 and with some movements 3. Evidence of this clinical pattern may be traced back to the earliest observations of the disorder.…”