Alleviating manoeuvres (sensory tricks) in cervical dystonia

Abstract

Background There is limited information on the phenomenology, clinical characteristics and pathophysiology of alleviating manoeuvres (AM), also called ‘sensory tricks’ in cervical dystonia (CD). Methods Individual data, collected from 10 sites participating in the Dystonia Coalition (http://clinicaltrials.gov/show/NCT01373424), included description of localisation and phenomenology of AM collected by systematic review of standardised video examinations. Analyses correlated demographic, neurologic, and psychiatric features of CD patients with or without effective AM. Results Of 154 people studied, 138 (89.6%) used AM, of which 60 (43.4%) reported partial improvement, 55 (39.8%) marked improvement, and 4 (0.03%) no effect on dystonic posture. Light touch, usually to the lower face or neck, was used by >90%. The presence or location of AM did not correlate with the severity of the dystonia. Conclusions In this large and comprehensive study of CD, we found no clinical predictors of effective AM. Further studies of sensorimotor integration in dystonia are needed to better understand the pathophysiology of AM.

Secured web-based video repository for multicenter studies

“…Another study investigated the nature of alleviating manuevers (sensory tricks) in 154 participants with cervical dystonia. [6]…”

“…Others have used the video sample to determine the relative frequency of tremor in people with various forms of idiopathic focal dystonia or the characteristics of sensory tricks in cervical dystonia. [6]…”

Sensory Tricks for Cervical Levodopa‐induced Dyskinesia in Patients with Parkinson's Disease

“…Choreiform or dystonic movement in the craniocervical region can occur as a levodopa ( l ‐dopa)‐induced dyskinesia (LID) in patients with Parkinson's disease (PD) . “Sensory tricks” are various alleviating maneuvers for the relief of abnormal postures in patients who have idiopathic focal dystonia, particularly those who have cervical dystonia (CD) . Here, we describe novel sensory tricks for cervical LID in patients with PD.…”

“…These tricks involved having a spouse grasp their ear or touch their chin. Sensory tricks, which are maneuvers that oppose the involuntary movement of the head and neck, are well‐known clinical features in patients with CD, particularly in those who have rotational torticollis . In a recent report of a large cohort of patients with CD, 83% of patients noted partial or marked benefit from the use of sensory tricks .…”

Examiner manoeuvres ‘sensory tricks’ in functional (psychogenic) movement disorders

“…The term ‘alleviating manoeuvres’ (AlM) has been proposed as a more appropriate term because ‘sensory trick’ suggests that only sensory input is required, and the word ‘trick’ wrongly implies that is ‘fake’ 2. ‘Reverse sensory trick’ is the term used when a manoeuvre worsens dystonia, the latter can also be called ‘aggravating manoeuvres’ (AgM).…”