Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous reports have attributed the development of premature cervical spondylosis to movement disorders such as torticollis and athetosis. This case report describes the clinical, electromyographic, and radiographic findings in a 34-year-old man who developed a myelopathy and cervical radiculopathy superimposed on a chronic dystonia of his neck and left arm. Cervical myeloradiculopathy should be suspected in any patient with a chronic movement disorder of the hand, neck, or arms, who presents with neurologic deterioration. Early diagnosis will lead to treatment that may improve symptoms. Anterior cervical bony fusion appears to be the preferred surgical treatment in these patients.
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PMID:Cervical spondylotic myeloradiculopathy in dystonia. 155 15

We studied 300 patients, 61% women, with mean age 49.7 years and mean duration of dystonia 7.8 years, to determine the demographic and clinical characteristics of cervical dystonia (CD) and its relationships to other movement disorders. Torticollis was present in 82%, laterocollis in 42%, retrocollis in 29%, and anterocollis in 25%; however, the majority (66%) had a combination of these abnormal postures. Scoliosis was present in 39%, local pain reported by 68%, and 32% had evidence of secondary cervical radiculopathy. In addition to CD, 16% of patients had oral dystonia, 12% mandibular dystonia, 10% hand/arm dystonia, and 10% had blepharospasm. Tremor was noted in 71% of patients; head-neck tremor was present in 60%, and tremor in other body regions was present in 32%. A family history of a movement disorder was present in 44% of the CD patients. Tardive dystonia was the cause in 6%; 11% had posttraumatic dystonia. Anticholinergic drugs provided moderate improvement in 33% of patients, but local intramuscular botulinum toxin injections relieved CD, local pain, or both in over 90% of all treated patients.
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PMID:Cervical dystonia: clinical findings and associated movement disorders. 206 38

Cervical spondylotic myelopathy usually arises in patients in their late 40s or early 50s, most frequently at the C5/6 and C6/7 levels. Recently, excellent results have been attained with microsurgery in cases of cervical spondylosis. On the other hand, treatment of cervical spondylotic myelopathy in patients with athetoid dystonic cerebral palsy entails several problems. The authors report three cases of such troublesome myelopathy. A 34-year-old male with severe athetoid movement showed cervical spondylotic myelopathy. Myelography and magnetic resonance (MR) imaging demonstrated compression of the spinal cord through the C3-C5 levels. A 47-year-old female with athetoid dystonic cerebral palsy presented myelopathy. Myelography and MR imaging showed instability and spinal cord compression at the C5/6 level. A 34-year-old male with spasmodic torticollis showed C6 radiculopathy due to cervical disc hernia at the C5/6 level. Cervical anterior decompression with interbody fusion brought temporary improvement in all the three patients. However, such problems as slippage of Halo-vest, difficulty in eating during Halo-vest fixation, relapse of neurological deficit, were experienced. Due to postoperative cervical instability, cervical laminectomy is considered to be contraindicated in such patients. Anterior decompression with bone fusion has been reported effective, but, if athetoid dystonia continues, there is a potential for myelopathic deterioration due to spondylotic changes adjacent to the fused vertebrae.
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PMID:[Surgical treatment of cervical spondylotic radiculomyelopathy with abnormal involuntary neck movements. Report of three cases]. 248 93

The development of transient right-sided lower cervical root impairment is reported in a 49-year-old woman affected by cervical dystonia, who had previously received botulinum toxin injections into the left sternocleidomastoid and the right trapezius. The possibility of a causal relationship was discussed with consideration of: 1) the absence of intercurrent illness or trauma; 2) the positive correlation between sensory-motor disturbances and the botulinum toxin-induced remission of cervical dystonia; 3) the reversibility of cervical radiculopathy (there was no recurrence in the two years following the interruption of the treatment). Magnetic resonance imaging investigation disclosed an abnormal cervical spine geometry together with moderate spondylosis. We feel that mechanical postural changes following the successful botulinum toxin treatment for cervical dystonia might have played some role in the development of cervical radiculopathy. Thus, skeletal abnormalities should be checked when attempting to correct muscle overactivity by botulinum toxin.
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PMID:Cervical radiculopathy following botulinum toxin therapy for cervical dystonia. 840 38

The screening of the nervous system function in 42 workers of copper rolled wire [correction of valzdrat] production and in 34 workers of aluminium rolled wire [correction of valzdrat] production was performed in 1992 and 1993 too; 52 healthy military men were investigated as control group. Target neurological anamnesis, internal and detailed neurological status were carried out. Symptoms of radiculopathy, neurasthenic syndrome and signs of generalized neurovegative dystonia were established in both studies--1992 and 1993. It is suggested that an further detailed investigation (including psychometric tests) is needed to verify of refute the neurotoxic effect of copper and aluminium.
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PMID:[The neurological screening of workers in the manufacture of copper and aluminum rolled wire]. 852 45

We report the transcranial sonography (TCS) findings of the basal ganglia in 86 patients with dystonic disorders including idiopathic dystonia (facial, cervical, upper limb, and generalized dystonia), drug-induced tardive dystonia, dopa-responsive dystonia, and kinesigenic dystonia. The TCS was focused on alterations of the lenticular, caudate, raphe nuclei, and the thalamus. Seventy-five percent of patient with idiopathic cervical and 83% of those with idiopathic upper limb dystonia had a hyperechogenic lesion of the middle segment of the lenticular nucleus on the side opposite to the clinical dystonic symptoms. The ipsilateral side was also affected in 20%. In facial dystonia, only one-third of the patients revealed lenticular nucleus lesions. The mean area of the lenticular nucleus lesion opposite to the clinically affected side was 30 mm2 in cervical dystonia, 17 mm2 in upper limb dystonia, and 7.5 mm2 in facial dystonia. These lenticular abnormalities were significantly more frequent (p < 0.001) and their areas were significantly greater (p < 0.001) compared with a control group of 50 patients afflicted with radiculopathy. There was a significant correlation of the severity of symptoms with the intensity of lenticular nucleus hyperechogenicity in patients with cervical and upper limb dystonia (p < 0.05). Increased caudate nucleus echogenicity was present in 20% of patients with cervical and upper limb dystonia, mostly contralateral to the clinically affected side and raphe abnormalities were present in 7% of all patients with idiopathic dystonia. In contrast, there were no abnormalities of the lenticular nucleus or thalamus in nonidiopathic dystonias. We conclude that idiopathic dystonia is associated with lesions in the basal ganglia, particularly the lenticular nucleus, that can be visualized by TCS. An alteration of the basal ganglia matrix may be the pathologic basis of idiopathic dystonia with secondary affliction of striatopallidothalamic pathways.
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PMID:Lenticular nucleus lesion in idiopathic dystonia detected by transcranial sonography. 890 44

Neurocysticercosis commonly presents with seizures, raised intracranial tension and dementia. The unusual location of the cysts may result in uncommon manifestations mimicking a host of neurological disorders. Ten patients with neurocysticercosis with rare clinical presentations have been described in this series. These include dorsal midbrain syndrome, isolated bilateral ptosis, papillitis, cerebral hemorrhage, painful cervical radiculopathy, progressive swelling of arm, paraplegia due to intramedullary cyst, third ventricular cyst, dystonia and nominal aphasia masquerading as transient ischaemic attacks. The clinical details and possible mechanisms for these rare presentations are discussed.
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PMID:Uncommon presentations of neurocysticercosis. 954 30

We describe 13 cases of isolated focal dystonia of the shoulder with dystonic elevation but without clinically obvious cervical dystonia. All had significant trapezius muscle hypertrophy and limitation of shoulder movement causing substantial morbidity. In nine, this developed in the immediate aftermath of shoulder region trauma, most often a motor vehicle accident; clinically significant head trauma was not a factor. In two other cases this developed in the context of chronic heavy labor (suggesting possible overuse) and in one other it developed concurrent with the symptoms of discogenic cervical (C6-7) radiculopathy. In the one remaining case, no precipitating factors were identified. Preexisting risk factors for dystonia, such as dopamine antagonist drug use, family history of dystonia, or prior brain injury, were not identified in these patients. Administration of medications used to treat dystonia was unsuccessful but botulinum toxin therapy was beneficial in all six treated cases.
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PMID:Focal shoulder-elevation dystonia. 1092 83

In a prospective series of 34 incident patients with primary cervical dystonia (CD), 6 showed clinical or radiological signs of cervical radiculopathy (RP) or myelopathy (MP) during the course of their movement disorder. Age at onset in these patients was in the range reported for pure spondylotic cervical RP without an accompanying movement disorder. Radiologically, spondylosis was mild in 1 case and absent in 2 cases. The intervals between onset of CD and RP were shorter than in literature reports of RP/MP in dystonic-athetotic patients of cerebral paresis. Clinically, RP/MP in patients with CD mostly appears at mid-cervical levels, whereas cases with cerebral paresis are more frequently affected at higher cervical segments. We propose that RP/MP does not occur more frequently in CD than in pure spondylotic cervical RP.
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PMID:Radiculopathy and myelopathy in patients with primary cervical dystonia. 1138 61

A 43-year-old man was admitted to our hospital due to unstable walking, head tilting to the left and difficulty in extending his arm. He was quite healthy until the age of 20 years, when these symptoms appeared and progressed slowly afterward. Due to his unstable walking, he started to use a wheelchair when he was 39 years old. He had no family history of similar disease. On admission, neurological examination revealed spasmodic torticollis, ataxic speech and marked limb and truncal ataxia. Myoclonic jerky flexion of the forearm was induced when he raised and extended his forearm. He also showed mild hyperreflexia in the lower limbs without pathological reflexes. He had weakness and atrophy of the left supraspinatus, infraspinatus, deltoid and biceps brachii muscles and mild superficial sensory impairment in the left axillary nerve territory due to cervical spondylotic radiculopathy of the left C5 root. MRI of the brain demonstrated severe bilateral atrophy of the cerebellar hemispheres and vermis but minimal atrophy of the cerebrum and brainstem. Because surface electromyography revealed continuous discharge with phasic components in the biceps and wrist flexor muscles on extending the upper limbs, the jerky flexion movement of the forearm was considered to be primarily dystonia. Although no giant SEP was observed, a C-response was detected in the long-loop reflex in response to right median nerve stimulation. Nuclear examinations showed diffuse hypoperfusion and decreased glucose metabolism in the cerebellum. Based on these findings, we hypothesized that cerebellar dysfunction may have induced severe dystonic movement resembling myoclonus. We would like to name this complicated involuntary movement an "arm thrust". This is the first case to be reported of sporadic, chronic, progressive cerebellar ataxia accompanied by severe dystonic movement, especially on stretching the forearms, that mimics myoclonic movement.
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PMID:[A case of cerebellar ataxia showing severe dystonia masquerading as myoclonic jerky movements on arm extension]. 1235 58


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