Acoustic reflex abnormalities in cranial‐cervical dystonia

Lew, Henry L.; Jordan, Craig E.; Jerger, James; Jankovic, Joseph

doi:10.1212/wnl.42.3.594

Cited by 12 publications

(6 citation statements)

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“…Abnormal acoustic reflex patterns of prolonged relaxation, latency times, and reduced amplitude have been associated with various neuromuscular disorders [4,6,9,10,11]. Among these studies, only one investigated the acoustic (stapedial) reflex in ALS patients.…”

Section: Discussionmentioning

confidence: 99%

Acoustic reflex patterns in amyotrophic lateral sclerosis

Canale

Albera

Lacilla

et al. 2016

Eur Arch Otorhinolaryngol

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The aim of the study is to investigate acoustic reflex testing in amyotrophic lateral sclerosis patients. Amplitude, latency, and rise time of stapedial reflex were recorded for 500 and 1000 Hz contralateral stimulus. Statistical analysis was performed by the Wilcoxon test and the level of significance was set at 5 %. Fifty-one amyotrophic lateral sclerosis patients and ten sex- and age-matched control subjects were studied. Patients were further divided in two groups: amyotrophic lateral sclerosis-bulbar (38 cases, with bulbar signs at evaluation) and amyotrophic lateral sclerosis-spinal (13 cases, without bulbar signs at evaluation). Stapedial reflex was present in all patients. There was a statistically significant difference in the mean amplitude, latency, and rise time between the amyotrophic lateral sclerosis patients as compared with the controls. Amplitude was lower in both the amyotrophic lateral sclerosis-bulbar and the amyotrophic lateral sclerosis-spinal patients than in the controls (p < 0.05) and rise time was longer in both patient groups compared with the controls (p < 0.05). These results confirm the presence of abnormal acoustic reflex patterns in amyotrophic lateral sclerosis cases with bulbar signs and, moreover, suggesting a possible subclinical involvement of the stapedial motor neuron even in amyotrophic lateral sclerosis-spinal patients. Amplitude and rise time seem to be good sensitive parameters for investigating subclinical bulbar involvement.

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Section: Discussionmentioning

confidence: 99%

Acoustic reflex patterns in amyotrophic lateral sclerosis

Canale

Albera

Lacilla

et al. 2016

Eur Arch Otorhinolaryngol

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“…In addition to the localization data presented in Table 1, the general idea that idiopathic cervical dystonia may not be due to a primary “basal ganglia” abnormality is suggested by a wide variety of physiological studies in humans. Acoustic reflex,52 blink reflex, and masseter inhibitory reflex abnormalities in patients with cervical dystonia indicate the presence of abnormally excitable brainstem interneuronal pathways 53. Impaired vestibulo‐collic54 and vestibulo‐ocular55 reflexes in patients with cervical dystonia and the appearance of cervical dystonia after unilateral vestibular nerve lesions56 strongly suggest that deficits in vestibulocerebellar function may play a role in this movement disorder.…”

Section: Discussionmentioning

confidence: 99%

Secondary cervical dystonia associated with structural lesions of the central nervous system

2002

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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.

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“…Structural lesions of the upper brainstem have been described in patients with cranial and cervical dystonia (19)(20)(21). Furthermore, abnormalities of the acoustic reflex, the blink reflex, and the vestibuloocular reflex have been found in patients with cranial-cervical dystonia (22)(23)(24). Additionally, disturbance of descending inhibitory pathways has been suggested, which may also explain the rare occurrence of dystonia with cervical spinal cord lesions (25,26).…”

Section: Discussionmentioning

confidence: 99%

Cervical dystonia associated with tumors of the posterior fossa

1997

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Cervical dystonia was associated with posterior fossa tumors in three patients. The onset of dystonia paralleled the appearance of other focal neurologic signs. All patients had extraaxial tumors located in the cerebellopontine angle that were removed via suboccipital approaches. The tumors were identified as schwannomas arising from the glossopharyngeal nerve and from the vagus/accessory nerves; and a meningioma. Postoperatively, the cervical dystonia improved markedly during a period of 8 years in one patient, and it remitted completely within 1 year in another patient. In the third patient, cervical dystonia persisted. The combination of the clinical findings and the temporal relationship of their appearance suggest a causal association between the posterior fossa tumors and cervical dystonia in three cases. Possible pathogenic mechanisms are reviewed.

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Acoustic reflex abnormalities in cranial‐cervical dystonia

Cited by 12 publications

References 0 publications

Acoustic reflex patterns in amyotrophic lateral sclerosis

Acoustic reflex patterns in amyotrophic lateral sclerosis

Secondary cervical dystonia associated with structural lesions of the central nervous system

Cervical dystonia associated with tumors of the posterior fossa

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