Complex mechanisms of sensory tricks in cervical dystonia

Muscle activities in 26 patients with predominantly rotational torticollis were quantified using surface electromyography. In the subgroup of 19 patients with an effective sensory trick, different modes and bilateral locations of trick application led to significant (P < 0.002) reduction of elect...

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Bibliographic Details
Published in:Movement disorders 2004-04, Vol.19 (4), p.452-458
Main Authors: Schramm, Axel, Reiners, Karlheinz, Naumann, Markus
Format: Article
Language:English
Subjects:
Biological and medical sciences
cervical dystonia
Electromyography - instrumentation
Female
gèste antagonistique
Humans
Male
Medical sciences
Middle Aged
Muscle, Skeletal - physiopathology
Neurology
Polysomnography - instrumentation
Rotation
Sensation - physiology
sensory tricks
Severity of Illness Index
torticollis
Torticollis - complications
Torticollis - diagnosis
Torticollis - physiopathology
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Summary:Muscle activities in 26 patients with predominantly rotational torticollis were quantified using surface electromyography. In the subgroup of 19 patients with an effective sensory trick, different modes and bilateral locations of trick application led to significant (P < 0.002) reduction of electromyographic (EMG) activity. A strong correlation was found between the efficacy of trick manoeuvres and the starting head position. Trick application in a neutral or even contralateral position was most effective while no reduction of muscle activity during trick application at the maximum dystonic head position was found (P < 0.001). We propose a two‐phase model: First, normalisation of head posture is obtained by counterpressure or volitional antagonistic muscle activity. In a second step, this position can be stabilised using sensory tricks challenging central adaption of distorted sensorimotor integration. © 2003 Movement Disorder Society
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.10689