Abstract
Patients with different types of focal dystonia may experience temporary improvement of their dystonic symptoms with certain maneuvers, such as touching the chin, cheek, or back of head in cervical dystonia; touching the eyelids in blepharospasm; or touching the writing hand in writer’s cramp. The “sensory trick” or “geste antagoniste” is a characteristic and unique feature and may serve as a diagnostic clue to the diagnosis of focal dystonia. The most common form occurs in cervical dystonia where placement of a finger on the chin may neutralize involuntary head movements. The tricks may be tactile or proprioceptive. Even imagining a particular maneuver may diminish dystonic spasms.
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Schramm A, Reiners K, Naumann M. Complex mechanisms of sensory tricks in cervical dystonia. Mov Disord. 2004;19:452–8.
Bhidayasiri R, Bronstein JM. Improvement of cervical dystonia: possible role of transcranial magnetic stimulation simulating sensory tricks effects. Med Hypotheses. 2005;64:941–5.
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The patient exhibits severe retrocollis with mild left laterocollis. He experiences significant pain when the dystonic jerks pull his neck backward. However, when he lightly places the fingers of his left hand on his chin, his neck remains in a nearly neutral position. Note that his neck begins to return to a neutral position even before he touches his chin, suggesting that the mechanism of the sensory trick is more than a simple counterpressure phenomenon.
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Bhidayasiri, R., Tarsy, D. (2012). Cervical Dystonia: Sensory Tricks. In: Movement Disorders: A Video Atlas. Current Clinical Neurology. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-426-5_43
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DOI: https://doi.org/10.1007/978-1-60327-426-5_43
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Publisher Name: Humana, Totowa, NJ
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