Classification and Diagnosis of Cervical Dystonia: Revived Call for Consensus

Pandey, Sanjay; Jost, Wolfgang H.

doi:10.1002/mdc3.13444

Cited by 2 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These recommendations have been widely adopted and successfully applied 7 . However, a recent analysis found that the delineation of iCD is not fully accounted for by the previously proposed general dystonia consensus 8,9 . In addition, the relationship between tremor and dystonia is particularly relevant for iCD patients, as approximately a half of them have head, neck, or upper limb tremor 10 .…”

Section: Introductionmentioning

confidence: 99%

“… 7 However, a recent analysis found that the delineation of iCD is not fully accounted for by the previously proposed general dystonia consensus. 8 , 9 In addition, the relationship between tremor and dystonia is particularly relevant for iCD patients, as approximately a half of them have head, neck, or upper limb tremor. 10 Currently, there is no test to definitively diagnose iCD, and the gold standard is a clinical diagnosis based on history, clinical features, and phenomenology.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Isolated Cervical Dystonia: Diagnosis and Classification

et al. 2023

View full text Add to dashboard Cite

This document presents a consensus on the diagnosis and classification of isolated cervical dystonia (iCD) with a review of proposed terminology. The International Parkinson and Movement Disorder Society Dystonia Study Group convened a panel of experts to review the main clinical and diagnostic issues related to iCD and to arrive at a consensus on diagnostic criteria and classification. These criteria are intended for use in clinical research, but also may be used to guide clinical practice. The benchmark is expert clinical observation and evaluation. The criteria aim to systematize the use of terminology as well as the diagnostic process, to make it reproducible across centers and applicable by expert and non‐expert clinicians. Although motor abnormalities remain central, increasing recognition has been given to nonmotor manifestations, which are incorporated into the current criteria. Three iCD presentations are described in some detail: idiopathic (focal or segmental) iCD, genetic iCD, and acquired iCD. The relationship between iCD and isolated head tremor is also reviewed. Recognition of idiopathic iCD has two levels of certainty, definite or probable, supported by specific diagnostic criteria. Although a probable diagnosis is appropriate for clinical practice, a higher diagnostic level may be required for specific research studies. The consensus retains elements proven valuable in previous criteria and omits aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of iCD expands, these criteria will need continuous revision to accommodate new advances. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Isolated Cervical Dystonia: Diagnosis and Classification

et al. 2023

View full text Add to dashboard Cite

show abstract

Cervical Dystonia with Tremor: One Movement Disorder or Two?

Kilic‐Berkmen

Jinnah

2022

Movement Disord Clin Pract

View full text Add to dashboard Cite

We thank Pandey and Jost for thoughtful comments 1 regarding our article on the diagnosis and classification of cervical dystonia (CD). 2 CD often is combined with dystonia in other body regions, and the main goal of our article was to develop empirically-derived guidelines for classification of phenomenological patterns according to body distributions affected as either focal, segmental, multifocal, or generalized.We agree tremor is common among individuals with CD 3 ; so it is important to question whether tremor should be considered when classifying body distributions affected. CD plus tremor of the head/neck would be considered a focal dystonia, because only one body region is affected. However, the combination of CD plus hand tremors would be considered a focal dystonia if only the dystonia is considered, but a multifocal dystonia if the hand tremors are also considered. An important point to consider is that consensus statements for dystonia 4 and tremor 5 have encouraged separation of phenomenology (Axis I) from etiology (Axis II). In keeping with these recommendations, results from our study 2 indicate that most movement disorder specialists do not consider tremor when classifying dystonia according to body distribution, at least at the phenomenological level. In other words, they view dystonia and tremor as two independently ascertainable motor phenomena. The separation of these two motor phenomenologies (Axis I) does not mean that there may be certain etiologies (Axis II) where tremor and dystonia are combined. However, our prior study did not address etiology.We also agree that clinical rating scales for dystonia have limitations, particularly when it comes to tremor. Despite the high co-prevalence of tremor and dystonia, the most popular dystonia scales do not assess tremor. Dystonia Coalition investigators recently revised and re-tested the most popular CD scale (TWSTRS), adding an item for head tremor to address this important shortcoming. 6 The tremor item did not fare well on a standard clinimetric property that assesses the item-to-total correlation. This property tests how one item relates to all of the rest of the items combined. The poor item-to-total correlation for the tremor item means that tremor severity did not correlate

show abstract

Classification and Diagnosis of Cervical Dystonia: Revived Call for Consensus

Cited by 2 publications

References 5 publications

Isolated Cervical Dystonia: Diagnosis and Classification

Isolated Cervical Dystonia: Diagnosis and Classification

Cervical Dystonia with Tremor: One Movement Disorder or Two?

Contact Info

Product

Resources

About