Dutta Debayan, Yadav Ravi
Department of Neurology, Shalby Hospital, Jabalpur, Madhya Pradesh 48600, India.
Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India.
Tremor Other Hyperkinet Mov (N Y). 2024 Dec 6;14:60. doi: 10.5334/tohm.915. eCollection 2024.
Dystonia is a common hyperkinetic movement disorder observed in various genetic, infective, drug-induced, and autoimmune disorders. Autoimmune disorders can present with isolated or combined acute or subacute dystonia. The pattern and approach to dystonia in autoimmune disorders are poorly described and have never been established in a structured manner.
This scoping review aims to summarize all available clinical literature and formulate a pattern and approach to dystonia in different autoimmune disorders.
We included one hundred and three articles in this scoping review. Most articles identified were case reports or case series.
In this review, we analysed data from 103 articles and summarized the epidemiological, clinical, and diagnostic features of dystonia associated with different autoimmune diseases. We highlight that dystonia can be isolated or combined in various autoimmune conditions and is responsive to immunotherapy. We point out the patterns of dystonia and associated neurological features and investigations that can suggest the underlying autoimmune nature, which can guide the most appropriate treatment.
The clinical pattern of dystonia can be a unique feature in many autoimmune disorders. In isolated subacute dystonia, the presence of autoantibodies could have a temporal association, or this is just an epiphenomenon to be evaluated in further research.
Many autoimmune disorders can present with isolated or combined dystonia.Subacute onset focal or segmental dystonia (craniocervical dystonia or limb dystonia) or hemidystonia could be secondary to an autoimmune condition and warrants investigations.They have a relapsing or progressive course.They usually have a good response to early immunotherapy.Symptomatic treatment, including botulinum toxin, can be useful in focal dystonia.
肌张力障碍是一种常见的运动亢进性疾病，可见于多种遗传性、感染性、药物性及自身免疫性疾病。自身免疫性疾病可表现为孤立性或合并性急性或亚急性肌张力障碍。目前对于自身免疫性疾病中肌张力障碍的模式及处理方法描述甚少，且从未以结构化方式确立。
本综述旨在总结所有可用的临床文献，并制定不同自身免疫性疾病中肌张力障碍的模式及处理方法。
本综述纳入了103篇文章。所确定的大多数文章为病例报告或病例系列。
在本综述中，我们分析了103篇文章的数据，总结了与不同自身免疫性疾病相关的肌张力障碍的流行病学、临床及诊断特征。我们强调，肌张力障碍在各种自身免疫性疾病中可为孤立性或合并性，且对免疫治疗有反应。我们指出了肌张力障碍的模式以及相关的神经学特征和检查，这些可提示潜在的自身免疫性质，从而指导最恰当的治疗。
肌张力障碍的临床模式在许多自身免疫性疾病中可能是一个独特特征。在孤立性亚急性肌张力障碍中，自身抗体的存在可能存在时间关联，或者这只是一个有待进一步研究评估的附带现象。
许多自身免疫性疾病可表现为孤立性或合并性肌张力障碍。亚急性起病的局灶性或节段性肌张力障碍（颅颈肌张力障碍或肢体肌张力障碍）或偏侧肌张力障碍可能继发于自身免疫性疾病，需要进行检查。它们有复发或进行性病程。它们通常对早期免疫治疗反应良好。对症治疗，包括肉毒毒素，对局灶性肌张力障碍可能有用。
