Ghika J, Regli F, Growdon J H
Service de Neurologie, CHUV, Lausanne, Switzerland.
J Neurol Sci. 1993 Jun;116(2):142-7. doi: 10.1016/0022-510x(93)90318-s.
Cranial dystonia is normally considered as a pure movement disorder. Sensory symptoms have not received much attention, but we found ill-defined pain, discomfort, distortion of sensory modalities, 'phantom' kinetic or postural sensations in the orofacial areas subsequently involved by the dyskinesia in all of 11 consecutive patients, preceding by weeks or months the motor syndrome. Physicians were often mislead, initially making diagnoses such as trigeminal neuralgia, dental problems, sicca syndrome, chronic conjunctivitis, glossitis or stomatitis. The patients reported that the orofacial movements were at first willingly performed in order to decrease the discomfort which was felt in these facial areas before the movements finally escaped voluntary control and became socially disturbing. We suspect that the sensory symptoms, for which no objective substrate could be found, and which were always reported before and in the exact location of the subsequent dyskinesia, could be the earliest manifestation of an evolving process in cranial and perhaps other focal dystonias.
颅肌张力障碍通常被视为一种单纯的运动障碍。感觉症状并未受到太多关注，但我们发现，在11例连续患者中，所有患者在口面部区域均出现了定义不清的疼痛、不适、感觉模式扭曲、“幻影”运动或姿势感觉，这些区域随后会出现运动障碍，且在运动综合征出现前数周或数月就已出现。医生常常被误导，最初会做出诸如三叉神经痛、牙齿问题、干燥综合征、慢性结膜炎、舌炎或口腔炎等诊断。患者报告称，口面部运动起初是为了减轻这些面部区域的不适感而主动进行的，最终这些运动不受自主控制并给社交带来困扰。我们怀疑，这些感觉症状在随后运动障碍出现之前及相同确切位置一直被报告，却找不到客观的病变基础，可能是颅部以及或许其他局灶性肌张力障碍演变过程的最早表现。
