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Author Notes:

Gonzalo J. Revuelta, Movement Disorders Program, 326 Calhoun Street, Suite 308/MSC 108, Charleston, SC 29425, United States. Tel.:+1 843 792 7262; fax: +1 843 792 1751. revuelta@musc.edu..

The authors report no conflict of interest concerning the research related to this manuscript.

Subjects:

Research Funding:

This study was supported by a grant from the Bachmann–Strauss Dystonia Parkinson Foundation and the NIH/NCRR (award number UL1RR029882).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences
  • Neurosciences & Neurology
  • Anterocollis
  • Head drop syndrome
  • Parkinson's disease
  • Dystonia
  • Myopathy
  • MULTIPLE SYSTEM ATROPHY
  • DROPPED HEAD SYNDROME
  • PROGRESSIVE SUPRANUCLEAR PALSY
  • NECK EXTENSOR MYOPATHY
  • DISPROPORTIONATE ANTECOLLIS
  • FOCAL MYOPATHY
  • DISEASE
  • CAMPTOCORMIA
  • DEFORMITIES
  • DYSTONIA

Clinical subtypes of anterocollis in parkinsonian syndromes

Tools:

Journal Title:

Journal of the Neurological Sciences

Volume:

Volume 315, Number 1-2

Publisher:

, Pages 100-103

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Disproportionate anterocollis is a debilitating condition which occurs in the later stages of parkinsonian syndromes and for which there is no effective therapy. Multiple hypotheses have been proposed to explain its underlying etiology, including myopathy of the cervical extensors, and dystonia of the cervical flexors. Methods: We examined the records of 39 patients (8 prospectively) with anterocollis and parkinsonian syndromes to explore demographics, historical and clinical data, findings from electromyography and response to therapies. We classified our patients based on whether or not they were weak on neck extension and also based on primary diagnosis (PD vs atypical parkinsonian syndrome). Demographic, clinical, historical and EMG features are reported for each group. Results: There were no significant demographic differences between clinical subtypes, or primary diagnosis. Electromyographic (EMG) findings demonstrated myopathic changes in both groups, although they were more prominent in the group which was weak in extension. Historical features were similar between groups except for dopamine agonist use, which was more common in the myopathic subgroup (p = 0.02). There were no other significant clinical differences between clinical subtypes or primary diagnosis with the exception that patients with atypical parkinsonian syndromes had more advanced motor symptoms. Conclusions: We conclude that anterocollis is a heterogeneous condition in which at least two distinct subtypes exist. Recognizing these subtypes may help guide therapy and future research.

Copyright information:

© 2011 Elsevier B.V. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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