Eighteen patients out of three large multigenerational families with genetically established spinocerebellar ataxia type 2 (SCA2) were examined with special attention to the presence of dystonic features. Cervical dystonia (CD) was diagnosed according to standardized clinical criteria. CD was scored using the Tsui-score. Polymyography was performed in 6 cases using bilateral surface electrode recordings of sternocleidomastoid and trapezius muscles together with needle electrode recordings of splenius capitis muscles bilaterally. CD was found in 11 out of 18 patients (61%), and was the presenting symptom in one case. Severity of CD was mild to moderate with Tsui scores ranging from 5 to 12 points. Polymyography in 6 out of 11 SCA2 patients with CD showed the typical pattern of dystonia with spontaneous, involuntary muscle activation at rest in at least one neck muscle with disturbed reciprocal inhibition of antagonistic neck muscles. CD appears to be a common clinical feature in SCA2 and may precede ataxia and gait disturbance. By contrast, none of the 18 patients had dystonic features in other body regions. CD has probably been underreported in patients with the ataxic SCA2 phenotype and should be considered as an additional clinical manifestation in patients with hereditary ataxia.
- cerebellar ataxia
- cervical dystonia
- spinocerebellar ataxia type 2
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