Rubio-Agusti I, Pareés I, Kojovic M, Stamelou M, Saifee TA, Charlesworth G, Sheerin UM, Edwards MJ, Bhatia KP. Tremulous cervical dystonia is likely to be familial: clinical characteristics of a large cohort.
Parkinsonism Relat Disord 2013;
19:634-8. [PMID:
23523105 DOI:
10.1016/j.parkreldis.2013.02.017]
[Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND
Primary cervical dystonia is the most common form of adult-onset focal dystonia. Although most frequently sporadic, 15-20% of patients report a positive family history, suggesting a possible genetic cause. Head tremor is often present in patients with cervical dystonia and may be a prominent symptom.
OBJECTIVE
To describe the clinical characteristics of patients with tremulous cervical dystonia.
METHODS
Patients with primary cervical dystonia attending our botulinum toxin clinic were assessed with an interview and neurological examination and their notes reviewed. Patients were classified as having either tremulous or non-tremulous cervical dystonia, according to the presence or absence of head tremor on examination. Clinical and demographic data were compared between groups.
RESULTS
From 273 patients included (190 females, 83 males), 125 (46%) were classified as tremulous and 148 (54%) as non-tremulous. Tremulous patients were more likely to have a segmental distribution (61% vs. 25%), often involving the arms (48%), and had more frequently associated arm tremor (55% vs. 10%). A positive family history of dystonia and/or tremor was more frequent in tremulous patients (50% vs. 18%).
CONCLUSIONS
Patients with cervical dystonia with associated head tremor are more likely to have a segmental distribution (with frequent arm involvement), associated arm tremor and a positive family history, suggesting a genetic etiology in this subgroup of patients.
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