Movement Disorders (revue)

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Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapse

Identifieur interne : 002764 ( PascalFrancis/Checkpoint ); précédent : 002763; suivant : 002765

Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapse

Auteurs : Georg Becker [Allemagne] ; Daniela Berg [Allemagne] ; Niels Kruse [Allemagne] ; Ute Schröder [Allemagne] ; Monika Warmuth-Metz [Allemagne] ; Peter Rieckmann [Allemagne] ; Markus Naumann [Allemagne] ; Karlheinz Reiners [Allemagne]

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RBID : Pascal:02-0456856

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English descriptors

Abstract

Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.


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<div type="abstract" xml:lang="en">Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.</div>
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<s1>P</s1>
</fA60>
<fA61>
<s0>A</s0>
</fA61>
<fA64 i1="01" i2="1">
<s0>Movement disorders</s0>
</fA64>
<fA66 i1="01">
<s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B25I</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Dystonie</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Dystonia</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Distonía</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Epaule</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Shoulder</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Hombro</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Hernie</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Hernia</s0>
<s5>04</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Hernia</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Disque intervertébral</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Intervertebral disk</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Disco intervertebral</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Rachis cervical</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Cervical spine</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Raquis cervical</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Exérèse</s0>
<s5>07</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Exeresis</s0>
<s5>07</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Exéresis</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Douleur</s0>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Pain</s0>
<s5>10</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Dolor</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Nuque</s0>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Nucha</s0>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Nuca</s0>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Echographie</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Echography</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Ecografía</s0>
<s5>13</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Voie transcrânienne</s0>
<s5>14</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Transcranial route</s0>
<s5>14</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Vía transcraneana</s0>
<s5>14</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE">
<s0>Complication</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG">
<s0>Complication</s0>
<s5>17</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA">
<s0>Complicación</s0>
<s5>17</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE">
<s0>Traitement</s0>
<s5>18</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG">
<s0>Treatment</s0>
<s5>18</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA">
<s0>Tratamiento</s0>
<s5>18</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE">
<s0>Physiopathologie</s0>
<s5>19</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG">
<s0>Pathophysiology</s0>
<s5>19</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA">
<s0>Fisiopatología</s0>
<s5>19</s5>
</fC03>
<fC03 i1="14" i2="X" l="FRE">
<s0>Adulte</s0>
<s5>20</s5>
</fC03>
<fC03 i1="14" i2="X" l="ENG">
<s0>Adult</s0>
<s5>20</s5>
</fC03>
<fC03 i1="14" i2="X" l="SPA">
<s0>Adulto</s0>
<s5>20</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Homme</s0>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Human</s0>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Hombre</s0>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Muscle strié pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Striated muscle disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Músculo estriado patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Système nerveux pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Nervous system diseases</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Sistema nervioso patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Trouble neurologique</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Neurological disorder</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Trastorno neurológico</s0>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Mouvement involontaire</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Involuntary movement</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Movimiento involuntario</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Extrapyramidal syndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Extrapyramidal syndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Extrapiramidal síndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Système ostéoarticulaire pathologie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Diseases of the osteoarticular system</s0>
<s5>45</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Sistema osteoarticular patología</s0>
<s5>45</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE">
<s0>Rachis pathologie</s0>
<s5>46</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG">
<s0>Spine disease</s0>
<s5>46</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA">
<s0>Raquis patología</s0>
<s5>46</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE">
<s0>Chirurgie</s0>
<s5>53</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG">
<s0>Surgery</s0>
<s5>53</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA">
<s0>Cirugía</s0>
<s5>53</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE">
<s0>Exploration ultrason</s0>
<s5>69</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG">
<s0>Sonography</s0>
<s5>69</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA">
<s0>Exploración ultrasonido</s0>
<s5>69</s5>
</fC07>
<fN21>
<s1>266</s1>
</fN21>
<fN82>
<s1>PSI</s1>
</fN82>
</pA>
</standard>
</inist>
<affiliations>
<list>
<country>
<li>Allemagne</li>
</country>
<region>
<li>Bavière</li>
<li>District de Basse-Franconie</li>
</region>
<settlement>
<li>Wurtzbourg</li>
</settlement>
<orgName>
<li>Université de Wurtzbourg</li>
</orgName>
</list>
<tree>
<country name="Allemagne">
<region name="Bavière">
<name sortKey="Becker, Georg" sort="Becker, Georg" uniqKey="Becker G" first="Georg" last="Becker">Georg Becker</name>
</region>
<name sortKey="Berg, Daniela" sort="Berg, Daniela" uniqKey="Berg D" first="Daniela" last="Berg">Daniela Berg</name>
<name sortKey="Kruse, Niels" sort="Kruse, Niels" uniqKey="Kruse N" first="Niels" last="Kruse">Niels Kruse</name>
<name sortKey="Naumann, Markus" sort="Naumann, Markus" uniqKey="Naumann M" first="Markus" last="Naumann">Markus Naumann</name>
<name sortKey="Reiners, Karlheinz" sort="Reiners, Karlheinz" uniqKey="Reiners K" first="Karlheinz" last="Reiners">Karlheinz Reiners</name>
<name sortKey="Rieckmann, Peter" sort="Rieckmann, Peter" uniqKey="Rieckmann P" first="Peter" last="Rieckmann">Peter Rieckmann</name>
<name sortKey="Schroder, Ute" sort="Schroder, Ute" uniqKey="Schroder U" first="Ute" last="Schröder">Ute Schröder</name>
<name sortKey="Warmuth Metz, Monika" sort="Warmuth Metz, Monika" uniqKey="Warmuth Metz M" first="Monika" last="Warmuth-Metz">Monika Warmuth-Metz</name>
</country>
</tree>
</affiliations>
</record>

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