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A Cochrane review published in 2016 reported moderate-quality evidence that a single Botulinum toxin-B treatment session could improve cervical dystonia symptoms by 10% to 20%, although with an increased risk of dry mouth and swallowing difficulties. [22] Another Cochrane review published in 2020 for Botulinum toxin-A found similar results. [23]
The symptoms usually begin between the ages of 30 and 70 years old and appear to be more common in women than in men (2:1 ratio). The combination of upper and lower dystonia is sometimes called cranial-cervical dystonia. [2] The incidence is about one case in 20,000 people. [3]
Dystonia is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles. [4] The disorder may be hereditary or caused by other factors such as birth-related or other physical trauma, infection, poisoning (e.g., lead poisoning) or reaction to pharmaceutical drugs, particularly neuroleptics, [3] or stress.
Differential diagnosis for torticollis includes [11] [28] Cranial nerve IV palsy; Spasmus nutans [29] Sandifer syndrome; Myasthenia gravis; Cerebrospinal fluid leak; Cervical dystonia appearing in adulthood has been believed to be idiopathic in nature, as specific imaging techniques most often find no specific cause. [30]
Myoclonic dystonia or Myoclonus dystonia syndrome is a rare movement disorder that induces spontaneous muscle contraction causing abnormal posture. The prevalence of myoclonus dystonia has not been reported, however, this disorder falls under the umbrella of movement disorders which affect thousands worldwide. [ 1 ]
Paroxysmal nocturnal dyspnea is a common symptom of several heart conditions such as heart failure with preserved ejection fraction, in addition to asthma, chronic obstructive pulmonary disease, and sleep apnea. [8] Other symptoms that may be seen alongside paroxysmal nocturnal dyspnea are weakness, orthopnea, edema, fatigue, and dyspnea. [9]
Sundowning is often a symptom that happens after someone is diagnosed with dementia or a dementia-related disease, but it can also be an early sign of mental decline itself. “There are changes ...
The diagnosis of focal dystonia is highly dependent on the history of the patient, as physical exam is typically normal, and ruling out other causes of movement disorder. [10] [11] The main types of are blepharospasm, oromandibular dystonia, spasmodic dysphonia, spasmodic torticollis, and limb dystonia, all affecting a different region of the ...