An unusual focal leg dystonia in descending stairs responsive to anticonvulsants

Yamamoto, Toshiyuki; Takiguchi, Naoko; Tamura, Naotoshi; Iwasaki, Shinichi; Araki, Nobuhito

doi:10.1016/j.clineuro.2011.07.013

Cited by 3 publications

(5 citation statements)

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“…Most of the studies were unremarkable, like the FTSD associated with repetitive exercise case series. Interestingly, one study showed hypoperfusion of the putamen and thalamus in 18 F-FDG PET, like the findings in some patients with paroxysmal kinesigenic dyskinesia (PKD) (10).…”

Section: Discussionmentioning

confidence: 73%

“…The mean age at initial diagnosis was 45.6 years (range, 21–67 years), and age of onset was 42 years (range, 20–56 years). The mean duration to diagnosis was 2.7 years (range, 0.7–10 years), except in two patients (patients 3 and 5) for whom the exact onset time and duration were unknown (10, 11). Patient symptoms affected both right ( n = 9) and left ( n = 8) sides similarly.…”

Section: Resultsmentioning

confidence: 99%

“…However, in the present FTSD associated with stairs case series, no medication or BoNT injection helped improve the dystonic symptom. Interestingly, Yamamoto et al found that the dystonia was highly responsive to a low dose of clonazepam and that 18 F-FDG PET showed hypoactivity in a circuit of the basal ganglia in their patients (10). On the basis of these findings, they presented that FTSD associated with stairs might be linked with PKD (10).…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, Yamamoto et al found that the dystonia was highly responsive to a low dose of clonazepam and that 18 F-FDG PET showed hypoactivity in a circuit of the basal ganglia in their patients (10). On the basis of these findings, they presented that FTSD associated with stairs might be linked with PKD (10). Two of our patients were treated with clonazepam also, but they did not respond to clonazepam, although they did not undergo 18 F-FDG PET.…”

Section: Discussionmentioning

confidence: 99%

“…If patients have FTSD in the lower limb or foot, they tend to complain of their symptoms occurring during walking, running, hiking, or cycling. In addition to these intense repetitive exercises as triggering factors, in several recent case reports (5–10) and series (11), patients with unusual ambulatory characteristics as triggering factors, which occur only when walking stairs, have been reported. The authors of the present study recently encountered five patients with this unique triggering factor, and with the combination of previously reported cases, the spectrum of FTSD in the lower limb only when walking stairs was analyzed.…”

Section: Introductionmentioning

confidence: 99%

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Focal Task-Specific Lower Limb Dystonia Only When Walking Stairs: Is It a New Disease Entity?

Baik

Lee

et al. 2019

Front. Neurol.

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Introduction: Focal task-specific dystonia in the lower limb or foot often occurs only during walking, running, hiking, or cycling. Several medications and botulinum toxin injection are effective in patients with this disorder. The objective of this study was to understand the spectrum of focal task-specific dystonia in the lower limb only when walking stairs and to compare other types of task-specific dystonia.Methods: All original articles and case reports were collected and reviewed using PubMed. In addition, all video clips of published cases were evaluated, and patients' clinical findings analyzed. The present study included 12 patients described in previous studies and five new Asian patients found in the medical records.Results: Most of the patients were women, and the onset age was 42 years. Ten patients were classified as the Kicking type, including three patients with the rKicking type, and six patients were considered as the Lifting type; however, only one patient was not included in any of the types. Symptoms in most of the patients did not improve with any medications or botulinum toxin injection. The symptoms of most patients did not change over a long time.Conclusion: Most patients showed the dystonic symptom when walking downstairs rather than upstairs. Psychogenic dystonia is a disease differentially diagnosed with this dystonia. Unlike other types of focal task-specific dystonia, the response to treatment was disappointing because most of the medications and botulinum toxin injection were not effective. The prognosis is completely different from that of other types of focal task-specific dystonia.

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Section: Discussionmentioning

confidence: 73%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Focal Task-Specific Lower Limb Dystonia Only When Walking Stairs: Is It a New Disease Entity?

Baik

Lee

et al. 2019

Front. Neurol.

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An unusual focal leg dystonia in descending stairs responsive to anticonvulsants – A comment

Karosin¹,

Kofler²,

Saltuari³

2012

Clinical Neurology and Neurosurgery

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Neurological disorders of gait, balance and posture: a sign-based approach

Nonnekes¹,

Goselink²,

Růžička

et al. 2018

Nat Rev Neurol

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Neurological disorders of gait, balance and posture are both debilitating and common. Adequate recognition of these so-called disorders of axial mobility is important as they can offer useful clues to the underlying pathology in patients with an uncertain clinical diagnosis, such as those early in the course of neurological disorders. Medical teaching programmes typically take classic clinical presentations as the starting point and present students with a representative constellation of features that jointly characterize a particular axial motor syndrome. However, patients rarely present in this way to a physician in clinical practice. Particularly in the early stages of a disease, patients might display just one (or at best only a few) abnormal signs of gait, balance or posture. Importantly, these individual signs are never pathognomonic for any specific disorder but rather come with an associated differential diagnosis. In this Perspective, we offer a new diagnostic approach in which the presenting signs are taken as the starting point for a focused differential diagnosis and a tailored search into the underlying neurological syndrome.

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An unusual focal leg dystonia in descending stairs responsive to anticonvulsants

Cited by 3 publications

References 5 publications

Focal Task-Specific Lower Limb Dystonia Only When Walking Stairs: Is It a New Disease Entity?

Focal Task-Specific Lower Limb Dystonia Only When Walking Stairs: Is It a New Disease Entity?

An unusual focal leg dystonia in descending stairs responsive to anticonvulsants – A comment

Neurological disorders of gait, balance and posture: a sign-based approach

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