Post-traumatic cervical dystonia: a distinct entity?
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.


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.


CONCLUSIONS
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.
Samii
A
A
Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
Pal
P K
PK
Schulzer
M
M
Mak
E
E
Tsui
J K
JK
D000328:Adult; D017668:Age of Onset; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000293:injuries; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000150:complications; D004421:Dystonia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D004422:Dystonia Musculorum Deformans / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications; D009334:Neck Muscles; D019547:Neck Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement; D011795:Surveys and Questionnaires
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins