Head tremor and pain in cervical dystonia

Vu, Jeanne P.; Lee, Ha Yeon; Chen, Qiyu; Cisneros, Elizabeth; Barbano, Richard L.; Goetz, Christopher G.; Jankovic, Joseph; Jinnah, Hyder A.; Perlmutter, Joel S.; Berman, Brian D.; Appelbaum, Mark I.; Stebbins, Glenn T.; Comella, Cynthia L.; Peterson, David A.

doi:10.1007/s00415-020-10378-5

Cited by 15 publications

(18 citation statements)

References 36 publications

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“…The other hyperkinetic movement disorder, which driving was assessed was cervical dystonia (CD), but no serious safety concerns were noted in a small study in which 10 patients were compared to healthy controls with the use of a simulator 22 . This is in contrast to our own experience with a large number of patients with CD, many of whom raise concerns about their driving because of head tremor, limitation of neck range of motion, and neck pain, although most experience improvement in these symptoms with local botulinum toxin injections 23 …”

Section: Case Seriescontrasting

confidence: 89%

“…22 This is in contrast to our own experience with a large number of patients with CD, many of whom raise concerns about their driving because of head tremor, limitation of neck range of motion, and neck pain, although most experience improvement in these symptoms with local botulinum toxin injections. 23 There is remarkable paucity of information about driving in patients with TS. In one case report of a 42-year-old truck driver with TS, beneficial effects on psychomotor functions related to driving performance was attributed to the use of Δ 9 -tetrahydrocannabinol (THC).…”

Section: Discussionmentioning

confidence: 99%

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Tourette Syndrome and Driving

Makhoul

Jankovic

2021

Movement Disord Clin Pract

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BackgroundBackground: Driving ability may be impaired in patients with various movement disorders, but it has not been studied in patients with Tourette syndrome (TS). Cases Cases: We describe a series of 6 patients from our large cohort of TS patients followed in our movement disorders clinic in whom severe tics have had interfered with their driving abilities. The motor tics involved facial muscles and caused visual impairment because of frequent blinking and transient blepharospasm (dystonic tic), but complex limb and truncal tics also seriously impacted their driving. Conclusions Conclusions: Although majority of patients with TS have no functional impairment, severe motor tics in some patients may adversely affect their driving ability, potentially causing danger to themselves and others. Screening for such troublesome tics should be considered in patients with TS, particularly in teenagers who are being evaluated for driver's licensing. Illustrative Cases Case 1The first case is a 17-year-old right-handed student who initially experienced involuntary movements as a toddler manifested by shrugging her shoulders or patting her stomach with her hands.

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Section: Case Seriescontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Tourette Syndrome and Driving

Makhoul

Jankovic

2021

Movement Disord Clin Pract

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“…With the exception of pitch (anterocollis vs. retrocollis), this directionality information is lost in clinical rating scales. Yet the directionality of pitch has been associated with likelihood of comorbid head tremor in CD 36 and in turn head tremor subtype is differentially associated with pain severity 37 . In our cohort, we found that there was no bias toward anterocollis versus retrocollis, left versus right in laterocollis (“tilt”, roll), and left versus right in torticollis (“rotation”, yaw).…”

Section: Discussionmentioning

confidence: 51%

Hold that pose: capturing cervical dystonia's head deviation severity from video

Zhang

Cisneros

Lee

et al. 2022

Ann Clin Transl Neurol

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Objective Deviated head posture is a defining characteristic of cervical dystonia (CD). Head posture severity is typically quantified with clinical rating scales such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Because clinical rating scales are inherently subjective, they are susceptible to variability that reduces their sensitivity as outcome measures. The variability could be circumvented with methods to measure CD head posture objectively. However, previously used objective methods require specialized equipment and have been limited to studies with a small number of cases. The objective of this study was to evaluate a novel software system—the Computational Motor Objective Rater (CMOR)—to quantify multi‐axis directionality and severity of head posture in CD using only conventional video camera recordings. Methods CMOR is based on computer vision and machine learning technology that captures 3D head angle from video. We used CMOR to quantify the axial patterns and severity of predominant head posture in a retrospective, cross‐sectional study of 185 patients with isolated CD recruited from 10 sites in the Dystonia Coalition. Results The predominant head posture involved more than one axis in 80.5% of patients and all three axes in 44.4%. CMOR's metrics for head posture severity correlated with severity ratings from movement disorders neurologists using both the TWSTRS‐2 and an adapted version of the Global Dystonia Rating Scale (rho = 0.59–0.68, all p <0.001). Conclusions CMOR's convergent validity with clinical rating scales and reliance upon only conventional video recordings supports its future potential for large scale multisite clinical trials.

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“…HT in the absence of any obvious cervical dystonia or any tremor of other body parts is described as isolated HT. Several studies have found that HT is often associated with cervical dystonia, neck pain, hand tremor and family history of tremor or other movement disorders, suggesting marked heterogeneity of underlying mechanisms ( 54 , 55 ). In a series of 241 first-degree relatives of ET patients, isolated transient HT was observed in 21% (vs. controls 2%) which provides support for the observation that HT with or without hand tremor may be a manifestation of ET ( 56 ).…”

Section: Overview Of the Axis-i Tremor Syndromesmentioning

confidence: 99%

Tremor Syndromes: An Updated Review

Lenka

Jankovic

2021

Front. Neurol.

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Tremor is the most commonly encountered movement disorder in clinical practice. A wide range of pathologies may manifest with tremor either as a presenting or predominant symptom. Considering the marked etiological and phenomenological heterogeneity, it would be desirable to develop a classification of tremors that reflects their underlying pathophysiology. The tremor task force of the International Parkinson Disease and Movement Disorders Society has worked toward this goal and proposed a new classification system. This system has remained a prime topic of scientific communications on tremor in recent times. The new classification is based on two axes: 1. based on the clinical features, history, and tremor characteristics and 2. based on the etiology of tremor. In this article, we discuss the key aspects of the new classification, review various tremor syndromes, highlight some of the controversies in the field of tremor, and share the potential future perspectives.

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Head tremor and pain in cervical dystonia

Cited by 15 publications

References 36 publications

Tourette Syndrome and Driving

Tourette Syndrome and Driving

Hold that pose: capturing cervical dystonia's head deviation severity from video

Tremor Syndromes: An Updated Review

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