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Post-traumatic Cervical Dystonia: A Distinct Entity?

  • A. Samii (a1), P.K. Pal (a2), M. Schulzer (a2), E. Mak (a2) and J.K.C. Tsui (a2)...

Abstract:

Background/Objective:

The incidence of head/neck trauma preceding cervical dystonia (CD) has been reported to be 5-21%. There are few reports comparing the clinical characteristics of patients with and without a history of injury. Our aim was to compare the clinical characteristics of idiopathic CD (CD-I) to those with onset precipitated by trauma (CD-T). Methods: We evaluated 114 consecutive patients with CD over a 9-month period. All patients were interviewed using a detailed questionnaire and had a neurological examination. Their clinical charts were also reviewed.

Methods:

We evaluated 114 consecutive patients with CD over a 9-month period. All patients were interviewed using a detailed questionnaire and had a neurological examination. Their clinical charts were also reviewed.

Results:

Fourteen patients (12%) had mild head/neck injury within a year preceding the onset of CD. Between the two groups (CD-I and CD-T), the gender distribution (F:M of 3:2), family history of movement disorders (32% vs. 29%), the prevalence of gestes antagonistes (65% vs. 64%), and response to botulinum toxin were similar. There were non-specific trends, including an earlier age of onset (mean ages 43.3 vs. 37.6), higher prevalence of neck pain (86% vs. 100%), head tremor (67% vs. 79%), and dystonia in other body parts (23% vs. 36%) in CD-T.

Conclusion:

CD-I and CD-T are clinically similar. Trauma may be a triggering factor in CD but this was only supported by non-significant trends in its earlier age of onset.

RÉSUMÉ: Introduction/Objectif:

L'incidence d'un traumatisme de la tête ou du cou précédant la dystonie cervicale (DC) serait de 5 à 21%. Il existe peu de publications comparant les caractéristiques cliniques des patients avec et sans histoire de traumatisme. Le but de cette étude était de comparer les caractéristiques cliniques de la DC idiopathique (DC-I) à celles de la DC précipitée par un traumatisme (DC-T).

Méthodes:

114 patients consécutifs présentant une DC ont été évalués sur une période de 9 mois. On leur a administré un questionnaire détaillé lors d'une entrevue et tous ont subi un examen neurologique. Tous les dossiers cliniques ont également été révisés.

Résultats:

Quatorze patients (12%) avaient subi un traumatisme léger au niveau de la tête ou du cou dans l'année précédant le début de la DC. La distribution quant au genre (F:M 3:2), à l'histoire familiale de désordre du mouvement (32% vs 37.6%), la prévalence de gestes antagonistes (65% vs 64%) et la réponse à la toxine botulique étaient semblables. Il y avait des tendances non spécifiques, dont un âge de début plus précoce (âge moyen 43.3 vs 37.6 ans), une prévalence plus élevée de douleurs cervicales (86% vs 100%), de tremblement de la tête (67% vs 79%) et de dystonie localisée à d'autres parties du corps (23% vs 36%) dans la DC-T.

Conclusions:

La DC-I et la DC-T sont semblables au point de vue clinique. Un traumatisme peut être le facteur déclenchant de la DC, mais ceci n'est supporté que par une tendance non significative à un âge de début plus précoce chez les patients de cette étude.

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Copyright

Corresponding author

Department of Neurology, Harborview Medical Center, Box 359775, 325 Ninth Ave, Seattle, WA 98104-2499, USA

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Post-traumatic Cervical Dystonia: A Distinct Entity?

  • A. Samii (a1), P.K. Pal (a2), M. Schulzer (a2), E. Mak (a2) and J.K.C. Tsui (a2)...

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