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Alleviating manoeuvres (sensory tricks) in cervical dystonia
  1. Neepa Patel1,
  2. John Hanfelt2,
  3. Laura Marsh3,
  4. Joseph Jankovic4,
  5. for the members of the Dystonia Coalition
  1. 1Department of Neurology and Neurotherapeutics, Center for Movement Disorders, University of Texas Southwestern, Dallas, Texas, USA
  2. 2Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
  3. 3Departments of Psychiatry and Neurology, Baylor College of Medicine, Houston, Texas, USA
  4. 4Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Joseph Jankovic, Parkinson's Disease Center, and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, The Smith Tower, Suite 1801, 6550 Fannin, Houston, Texas 77030, USA; josephj{at}bcm.edu

Abstract

Background There is limited information on the phenomenology, clinical characteristics and pathophysiology of alleviating manoeuvres (AM), also called ‘sensory tricks’ in cervical dystonia (CD).

Methods Individual data, collected from 10 sites participating in the Dystonia Coalition (http://clinicaltrials.gov/show/NCT01373424), included description of localisation and phenomenology of AM collected by systematic review of standardised video examinations. Analyses correlated demographic, neurologic, and psychiatric features of CD patients with or without effective AM.

Results Of 154 people studied, 138 (89.6%) used AM, of which 60 (43.4%) reported partial improvement, 55 (39.8%) marked improvement, and 4 (0.03%) no effect on dystonic posture. Light touch, usually to the lower face or neck, was used by >90%. The presence or location of AM did not correlate with the severity of the dystonia.

Conclusions In this large and comprehensive study of CD, we found no clinical predictors of effective AM. Further studies of sensorimotor integration in dystonia are needed to better understand the pathophysiology of AM.

Keywords
  • sensory
  • sensory trick
  • geste antagoniste
  • cervical dystonia
  • sensorimotor integration

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