title: The role of cerebellum in patients with late onset cervical/segmental dystonia?--evidence from the clinic.
abstract: BACKGROUND
  There is evidence from animal studies, post-mortem pathology, functional imaging and neurophysiological studies to suggest that the cerebellum may be involved in the pathophysiology of dystonia. We sought to explore further the association of clinical and radiological abnormalities of the cerebellum in patients with dystonia.
  
  
  METHODS
  We retrospectively reviewed patients from our movement disorders research database, with predominant cervical dystonia who have been seen within last 6 months and had available routine magnetic resonance imaging (MRI). The clinical details including presence of cerebellar signs, imaging findings and results of investigations were recorded on a proforma. The results were analysed using percentages and means with standard deviation.
  
  
  RESULTS
  Out of 188 patients included 26 had evidence of cerebellar abnormality on neuroimaging. 17 patients showed cerebellar atrophy and 10 of these had cerebellar signs on examination. These patients were tested negative for common inherited ataxias. 9 patients had cerebellar lesions on MRI, reported as low grade tumour (n = 2), cerebellar infarct (n = 3), cyst (n = 2), white matter hyperintensity (n = 1) and ectopia (n = 1) out of these 4 had cerebellar signs.
  
  
  CONCLUSIONS
  The findings from our study suggest that there may be overt clinical or radiological cerebellar involvement in 14% of cases with cervical/segmental dystonia. However, larger prospective studies are needed in this context.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Batla
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Hospital Clínico Universitario Virgen de la Arrixaca, Neurology Department, Murcia, Spain.
authors.forename: M C
authors.initials: MC
authors.lastname: Sánchez
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Erro
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ganos
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Second Dept of Neurology, Kapodistrian University of Athens, Greece; Neurology Clinic, Philipps University, Marburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stamelou
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Department of Neurology, University Hospital Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Balint
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom; Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Brugger
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Antelmi
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom. Electronic address: k.bhatia@ion.ucl.ac.uk.
authors.forename: K P
authors.initials: KP
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D002526:Cerebellar Diseases / Q000473:pathology*; D004421:Dystonia / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014103:Torticollis / Q000473:pathology
keywords: Ataxia; Atrophy; Cerebellum; Cervical; Craniocervical; Dystonia; Segmental