Asmus Friedrich, von Coelln Rainer, Boertlein Axel, Gasser Thomas, Mueller Joerg
Department of Neurodegenerative Diseases, Center of Neurology, Hertie-Institute for Clinical Brain Research, Tuebingen, Germany.
Mov Disord. 2009 Jan 30;24(2):297-300. doi: 10.1002/mds.22406.
Sensory gestes (SG) are a pathognomonic sign of dystonia, which can be detected in up to two thirds of patients with cervical dystonia (CD). They reduce dystonia severity markedly but transiently. We report a patient whose CD substantially worsened with sensory input to the back of the head and neck in different body postures, a phenomomen recently termed "reverse" sensory geste (rSG) in craniocervical dystonia. In a cohort of CD outpatients, screening for "reverse" effects of SG on dystonia yielded a prevalence of 12.8% (n = 6/47). The most frequent rSG pattern was increased dystonic activity in a supine, resting position while trying to fall asleep. The response to rSG persisted throughout the course of the disease arguing for an impairment of central integration of neck proprioception. Assessment of rSG should be included in the routine examination of CD patients, since BTX treatment may have to beadjusted accordingly to be efficacious.
感觉性姿态（SG）是肌张力障碍的一种特征性体征，在多达三分之二的颈部肌张力障碍（CD）患者中可以检测到。它们能显著但短暂地减轻肌张力障碍的严重程度。我们报告了一名患者，其CD在不同身体姿势下，当头部和颈部后部受到感觉输入时会显著恶化，这种现象最近在颅颈肌张力障碍中被称为“反向”感觉性姿态（rSG）。在一组CD门诊患者中，筛查SG对肌张力障碍的“反向”影响，患病率为12.8%（n = 6/47）。最常见的rSG模式是在仰卧、休息状态下试图入睡时肌张力障碍活动增加。对rSG的反应在疾病过程中持续存在，这表明颈部本体感觉的中枢整合存在障碍。对CD患者的常规检查应包括对rSG的评估，因为可能必须相应调整肉毒毒素治疗才能有效。
