Samii A, Pal P K, Schulzer M, Mak E, Tsui J K
Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
Can J Neurol Sci. 2000 Feb;27(1):55-9. doi: 10.1017/s0317167100051982.
BACKGROUND/OBJECTIVE: The incidence of head/neck trauma preceding cervical dystonia (CD) has been reported to be 5-21%. There are few reports comparing the clinical characteristics of patients with and without a history of injury. Our aim was to compare the clinical characteristics of idiopathic CD (CD-I) to those with onset precipitated by trauma (CD-T).
We evaluated 114 consecutive patients with CD over a 9-month period. All patients were interviewed using a detailed questionnaire and had a neurological examination. Their clinical charts were also reviewed.
Fourteen patients (12%) had mild head/neck injury within a year preceding the onset of CD. Between the two groups (CD-I and CD-T), the gender distribution (F:M of 3:2), family history of movement disorders (32% vs. 29%), the prevalence of gestes antagonistes (65% vs. 64%), and response to botulinum toxin were similar. There were non-specific trends, including an earlier age of onset (mean ages 43.3 vs. 37.6), higher prevalence of neck pain (86% vs. 100%), head tremor (67% vs. 79%), and dystonia in other body parts (23% vs. 36%) in CD-T.
CD-I and CD-T are clinically similar. Trauma may be a triggering factor in CD but this was only supported by non-significant trends in its earlier age of onset.
背景/目的：据报道，颈肌张力障碍（CD）之前发生头/颈部创伤的发生率为5%-21%。比较有和没有受伤史患者临床特征的报告很少。我们的目的是比较特发性CD（CD-I）与创伤诱发型CD（CD-T）的临床特征。
我们在9个月内评估了114例连续的CD患者。所有患者均使用详细问卷进行访谈并接受神经学检查。我们还查阅了他们的临床病历。
14例患者（12%）在CD发病前一年内有轻度头/颈部损伤。在两组（CD-I和CD-T）之间，性别分布（女性：男性为3:2）、运动障碍家族史（32%对29%）、对抗性动作的发生率（65%对64%）以及对肉毒杆菌毒素的反应相似。CD-T存在一些非特异性趋势，包括发病年龄较早（平均年龄43.3岁对37.6岁）、颈部疼痛发生率较高（86%对100%）、头部震颤（67%对79%）以及其他身体部位肌张力障碍（23%对36%）。
CD-I和CD-T在临床上相似。创伤可能是CD的触发因素，但这仅得到其发病较早这一非显著趋势的支持。
