Secondary cervical dystonia associated with structural lesions of the central nervous system.
Identifieur interne : 000978 ( Ncbi/Checkpoint ); précédent : 000977; suivant : 000979Secondary cervical dystonia associated with structural lesions of the central nervous system.
Auteurs : Mark S. Ledoux [États-Unis] ; Kimberly A. BradySource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Adult, Afferent Pathways (physiopathology), Aged, Basal Ganglia Diseases (complications), Basal Ganglia Diseases (diagnosis), Basal Ganglia Diseases (physiopathology), Brain Diseases (complications), Brain Diseases (diagnosis), Brain Diseases (physiopathology), Cerebellar Diseases (complications), Cerebellar Diseases (diagnosis), Cerebellar Diseases (physiopathology), Cerebellum (physiopathology), Cerebral Infarction (complications), Cerebral Infarction (diagnosis), Cerebral Infarction (physiopathology), Diagnosis, Differential, Dominance, Cerebral (physiology), Humans, Male, Middle Aged, Olivary Nucleus (physiopathology), Torticollis (diagnosis), Torticollis (etiology), Torticollis (physiopathology).
- MESH :
- complications : Basal Ganglia Diseases, Brain Diseases, Cerebellar Diseases, Cerebral Infarction.
- diagnosis : Basal Ganglia Diseases, Brain Diseases, Cerebellar Diseases, Cerebral Infarction, Torticollis.
- etiology : Torticollis.
- physiology : Dominance, Cerebral.
- physiopathology : Afferent Pathways, Basal Ganglia Diseases, Brain Diseases, Cerebellar Diseases, Cerebellum, Cerebral Infarction, Olivary Nucleus, Torticollis.
- Adult, Aged, Diagnosis, Differential, Humans, Male, Middle Aged.
Abstract
We tested the hypothesis that structural lesions of the central nervous system (CNS) associated with cervical dystonia more commonly involve the cerebellum and its primary afferent pathways than basal ganglia structures. Cervical dystonia is the most common focal dystonia, the majority of cases are idiopathic, and only a small percentage of patients have a family history of dystonia or other movement disorders. Pathophysiological mechanisms operative in solely or predominantly appendicular dystonias such as writer's cramp and Oppenheim's dystonia, respectively, may not be directly applicable to axial dystonias. The localization of structural lesions of the CNS associated with secondary cervical dystonia may provide some insight into the neural structures potentially involved in primary cervical dystonia. The National Library of Medicine Gateway (from 1960) and a clinical database maintained by the senior author (from 1999) were searched for cases of secondary cervical dystonia associated with structural lesions of the CNS. Search terms included one or more of the following: dystonia, torticollis, cervical, secondary, and symptomatic. Lesion localization and type, patient age, patient gender, head position, occurrence of sensory tricks, and associated neurological findings were tabulated for each case. Structural lesions associated with cervical dystonia were most commonly localized to the brainstem and cerebellum. The remaining cases were equally divided between the cervical spinal cord and basal ganglia. Although inconsistent, head rotation tended to be contralateral to lesion localization. Additional neurological abnormalities were present in the majority of patients with secondary cervical dystonia. The relative paucity of basal ganglia pathology and concentration of lesions in the brainstem, cerebellum, and cervical spinal cord in patients with secondary cervical dystonia suggests that dysfunction of cerebellar afferent pathways may be important to the pathophysiology of primary cervical dystonia.
DOI: 10.1002/mds.10301
PubMed: 12518301
Affiliations:
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pubmed:12518301Le document en format XML
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<author><name sortKey="Ledoux, Mark S" sort="Ledoux, Mark S" uniqKey="Ledoux M" first="Mark S" last="Ledoux">Mark S. Ledoux</name>
<affiliation wicri:level="2"><nlm:affiliation>University of Tennessee Health Science Center, Department of Neurology, Memphis, Tennessee 38163 USA. mledoux@utmem.edu</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Tennessee</region>
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<wicri:cityArea>University of Tennessee Health Science Center, Department of Neurology, Memphis</wicri:cityArea>
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<author><name sortKey="Brady, Kimberly A" sort="Brady, Kimberly A" uniqKey="Brady K" first="Kimberly A" last="Brady">Kimberly A. Brady</name>
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<affiliation wicri:level="2"><nlm:affiliation>University of Tennessee Health Science Center, Department of Neurology, Memphis, Tennessee 38163 USA. mledoux@utmem.edu</nlm:affiliation>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Basal Ganglia Diseases (complications)</term>
<term>Basal Ganglia Diseases (diagnosis)</term>
<term>Basal Ganglia Diseases (physiopathology)</term>
<term>Brain Diseases (complications)</term>
<term>Brain Diseases (diagnosis)</term>
<term>Brain Diseases (physiopathology)</term>
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<term>Cerebellar Diseases (diagnosis)</term>
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<term>Cerebral Infarction (physiopathology)</term>
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<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
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<term>Torticollis (diagnosis)</term>
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<term>Brain Diseases</term>
<term>Cerebellar Diseases</term>
<term>Cerebral Infarction</term>
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<term>Brain Diseases</term>
<term>Cerebellar Diseases</term>
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<term>Torticollis</term>
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<term>Cerebral Infarction</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Diagnosis, Differential</term>
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<front><div type="abstract" xml:lang="en">We tested the hypothesis that structural lesions of the central nervous system (CNS) associated with cervical dystonia more commonly involve the cerebellum and its primary afferent pathways than basal ganglia structures. Cervical dystonia is the most common focal dystonia, the majority of cases are idiopathic, and only a small percentage of patients have a family history of dystonia or other movement disorders. Pathophysiological mechanisms operative in solely or predominantly appendicular dystonias such as writer's cramp and Oppenheim's dystonia, respectively, may not be directly applicable to axial dystonias. The localization of structural lesions of the CNS associated with secondary cervical dystonia may provide some insight into the neural structures potentially involved in primary cervical dystonia. The National Library of Medicine Gateway (from 1960) and a clinical database maintained by the senior author (from 1999) were searched for cases of secondary cervical dystonia associated with structural lesions of the CNS. Search terms included one or more of the following: dystonia, torticollis, cervical, secondary, and symptomatic. Lesion localization and type, patient age, patient gender, head position, occurrence of sensory tricks, and associated neurological findings were tabulated for each case. Structural lesions associated with cervical dystonia were most commonly localized to the brainstem and cerebellum. The remaining cases were equally divided between the cervical spinal cord and basal ganglia. Although inconsistent, head rotation tended to be contralateral to lesion localization. Additional neurological abnormalities were present in the majority of patients with secondary cervical dystonia. The relative paucity of basal ganglia pathology and concentration of lesions in the brainstem, cerebellum, and cervical spinal cord in patients with secondary cervical dystonia suggests that dysfunction of cerebellar afferent pathways may be important to the pathophysiology of primary cervical dystonia.</div>
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<region><li>Tennessee</li>
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<country name="États-Unis"><region name="Tennessee"><name sortKey="Ledoux, Mark S" sort="Ledoux, Mark S" uniqKey="Ledoux M" first="Mark S" last="Ledoux">Mark S. Ledoux</name>
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