Advertisement

Cervical Dystonia: Torticollis with Dystonic Head Tremor

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Cervical dystonia (CD) is often associated with dystonic head tremor. In some cases, the head tremor is much more apparent than the abnormal head posture which may be relatively subtle. Differential diagnosis includes titubation and essential tremor limited to the head and neck. Titubation occurs as a component of midline cerebellar ataxia and is accompanied by cerebellar findings. Essential tremor affecting the head is more jerky and irregular than dystonic tremor, rarely occurs in isolation, and is nearly always associated with postural or action tremor of the upper extremities or voice tremor (see Chap. 25). Dystonic head tremor is often but not always more prominent when the patient attempts to turn the head away from the abnormal head posture.

Keywords

Internal Medicine Differential Diagnosis Essential Tremor Cerebellar Ataxia Cervical Dystonia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

5 CD - Torticollis w. dystonic head tremor.mp4 (mp4 7,293kB)

At rest, the patient exhibits 25° of right-sided rotation with continuous, irregular horizontal head tremor. Rotational range of motion is full. There is no postural tremor in the upper extremities.

References

  1. 1.
    Chan J, Brin M, Fahn S. Idiopathic cervical dystonia: clinical characteristics. Mov Disord. 1991;6:119–26.PubMedCrossRefGoogle Scholar
  2. 2.
    Jankovic J, Leder S, Warner D, et al. Cervical dystonia: clinical findings and associated movement disorders. Neurology. 1991;41:1088–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Dauer WT, Burke RE, Greene P, Fahn S. Current concepts on the clinical features, aetiology and management of idiopathic cervical dystonia. Brain. 1998;121:547–60.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

Personalised recommendations