The dystonias.

Marsden, C. D.; Quinn, Niall

doi:10.1136/bmj.300.6718.139

Cited by 117 publications

(40 citation statements)

References 17 publications

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“…Dystonia may be persistent or intermittent, evoked only in specific situations, particularly during skilled activities using the affected part of the body, or in socially fraught situations. 9 Tardive dystonia arises after treatment with neuroleptic medication, and may not abate when the drug is discontinued. Oro-facial movements are common manifestations, and jaw-opening dystonia can occur.…”

Section: Discussionmentioning

confidence: 99%

Recurrent dislocation of the temporomandibular joints: a diagnostic and treatment problem

Wood

2002

Br Dent J

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Section: Discussionmentioning

confidence: 99%

Recurrent dislocation of the temporomandibular joints: a diagnostic and treatment problem

Wood

2002

Br Dent J

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“…Em sua maior parte, as distonias primárias focais do adulto são esporádicas enquanto as formas generalizadas da infância podem ser familiares e não familiares 18 ' 34 . As formas familiares são mais prevalentes em determinados grupos étnicos como em judeus da extração Ashkenazi 4 .…”

Section: Etiologiaunclassified

“…São aliviados com repouso, relaxamento, sono leve e com os chamados "truques sensitivos" que consistem em estímulos táteis ou proprioceptivos produzidos pelo paciente em pontos específicos da região do corpo acometida com o objetivo de reduzir a contração muscular excessiva 18 . Nas fases profundas do sono os movimentos distônicos desaparecem por completo 34 .…”

Section: Fen0men0l0gia Do Movimento Distônicounclassified

“…A forma generalizada apresentou prevalência de 34 por IO 6 , maior que a encontrada na população de Israel (11 por IO 6 ) 27 e menor do que a da população de raça judaica residente na cidade de Nova York (58 por IO 6 ) 16 . Segundo estimativas de Marsden 34 , considerando-se uma porcentagem adicional de 45% para as distonias generalizadas secundárias e de 10% para as distonias focais secundárias, a prevalência total seria de 391 por 10 a . Na Tabela 3 são mostrados comparativamente os números relativos à prevalência de diversas doenças neurológicas segundo dados de Rochester.…”

Section: Aspectos Demográficosunclassified

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Distonias: conceitos, classificação e fisiopatologia

Limongi

1996

Arq. Neuro-Psiquiatr.

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RESUMO -Pacientes portadores de movimentos distônicos têm sido relatados na literatura desde o fim do século passado. A conceituação clínica do movimento distônico tem sido debatida. Atualmente, é definida como uma síndrome de contrações musculares mantidas, frequentemente causando movimentos repetitivos ou de torção, ou posturas anormais. Distonias costumam ser classificadas segundo três critérios: distribuição, idade de início e etiologia. As formas generalizadas costumam iniciar-se na infância enquanto as formas focais quase sempre se iniciam na idade adulta. Movimentos e posturas distônicas podem ocorrer durante o repouso ou apenas durante o movimento voluntário. Geralmente pioram ou são desencadeados pela adoção de posturas específicas. Não se conhecem os mecanismos fisiopatológicos responsáveis pelo aparecimento da distonia. Evidências obtidas a partir do estudo das formas secundárias sugerem o envolvimento de algumas regiões dos núcleos da base, particularmente o putâmen e o globo pálido. PALAVRAS-CHAVE: distonia, núcleos da base, síndromes distônicas. Dystonias: concepts, classification and pathophysiologyABSTRACT -Since the last decades of the past century there have been several reports in the medical literature describing patients with dystonia. The clinical and phenomenological concepts of dystonic movements have been debated. Presently, dystonia is defined as a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements, or abnormal postures. Dystonia is usually classified according to three criteria: distribution, age of onset and etiology. The generalized forms often have their onset at childhood whereas the focal forms are most commonly seen in adults. Dystonic movements and postures can occur during resting or they can be precipitated by voluntary movements or by the adoption of specific posture patterns.The pathophysiologic mechanisms related to the appearance of dystonia are presently unknown. However, there are compelling evidences suggesting the involvement of some basal ganglia nuclei (e.g.putamen and globus palidus) in the development of dystonia. KEY-WORDS: dystonia, basal ganglia, dystonic syndromes. ASPECTOS HISTÓRICOS E CONCEITUAISAs primeiras descrições de pacientes com distonia apareceram esporadicamente na literatura médica a partir do final do século passado. Segundo Fahn 18 , Gowers, em 1888, utilizou o termo "coréia tetanóide" para descrever movimentos anormais lentos e persistentes em dois irmãos que mais tarde viriam a ser reconhecidos como portadores da doença de Wilson. Vários outros termos foram utilizados nessa época como, por exemplo, "espasmos histéricos", "mioclonia do tronco", "câimbras tônicas " e

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“…1 These muscle contractions typically result in more or less sustained movements or abnormal postures of the head. 23 In addition, the disorder is often complicated by cervical spinal pain 4 - 5 and impaired quality of life.…”

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confidence: 99%

Relationship Between Sleep, Neck Muscle Activity, and Pain in Cervical Dystonia

Lobbezoo

Thon

Rémillard

et al. 1996

Can. j. neurol. sci.

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Objective: The interactions between sleep, neck muscle activity, and cervical spinal pain were examined in a controlled study with nine patients suffering from idiopathic cervical dystonia (ICD; also referred to as spasmodic torticollis), and nine gender-and age-matched controls. Methods: From each participant, two all-night polysomnograms with additional electromyographic recordings from the sternocleidomastoid and upper trapezius muscles were obtained. The first night was for habituation to the laboratory environment; the second night for experimental data collection. Visual analogue scales were used to collect intensity and unpleasantness ratings of cervical spinal pain before and after the second sleep recording. Results: None of the standard sleep variables showed statistically significant differences between average values of both groups of participants. However, a significantly larger variance in sleep latency was obtained for the ICD patients. In general, abnormal cervical muscle activity decreased immediately when lying down without the intention to go to sleep. Subsequently, abnormal muscle contractions were gradually abolished in all ICD patients during the transition from relaxed wakefulness to light NREM sleep. Following this transition phase, no more abnormal EMG activity was found in any of our patients. Finally, cervical spinal pain intensity and unpleasantness were reduced by about 50% overnight. Conclusions: Both supine position and sleep can be associated with an improvement of symptoms of ICD, and this disorder does not induce any sleep perturbations. RESUME: Interrelation entre sommeil, activity musculaire et douleur dans le cas de dystonie cervicale. Objectif: Le but de cette 6tude 6tait de mettre en evidence les liens possibles entre le sommeil, l'activite musculaire (trapeze et sterno-cl6ido-mastoi'dien) et la douleur cervicale chez neuf patients prdsentant une dystonie cervicale idiopathique (torticolis spasmodique) par rapport a neuf sujets tfimoins, appari6s pour l'age et le sexe. Methode: L'activite polysomnographique et musculaire ainsi que la douleur ont e;t6 dtudi6es. Seules les donnees de la deuxieme nuit sont prSsentdes, la premiere nuit servant d'adaptation aux conditions expdrimentales. Resultats: Aucune des variables de sommeil n'a permis de differencier les deux groupes. Toutefois, la variance de la variable "latence du sommeil" fitait significativement plus importante chez les patients ayant une dystonie cervicale idiopathique. Ces memes patients ont d6montr6 une chute de l'activite' 61ectromyographique cervicale anormale, ce en position couchee sans intention de dormir. Cette activity diminuait graduellement au d£but de l'endormissement et aucune activity anormale ne subsistait lorsque la premiere peYiode de sommeil "lent lfiger" a dtd atteinte. Enfin, il est a noter qu'une diminution d'environ 50% de la douleur a 6t6 rapport6e, sur une dchelle visuelle analogue, en relation avec la baisse d'activit6 musculaire en cours de sommeil. Conclusions: La position couchee...

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The dystonias.

Cited by 117 publications

References 17 publications

Recurrent dislocation of the temporomandibular joints: a diagnostic and treatment problem

Recurrent dislocation of the temporomandibular joints: a diagnostic and treatment problem

Distonias: conceitos, classificação e fisiopatologia

Relationship Between Sleep, Neck Muscle Activity, and Pain in Cervical Dystonia

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