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Expert recommendations for diagnosing cervical, oromandibular, and limb dystonia
- Source :
- Neurological Sciences. 40:89-95
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Background: Diagnosis of focal dystonia is based on clinical grounds and is therefore open to bias. To date, diagnostic guidelines have been only proposed for blepharospasm and laryngeal dystonia. To provide practical guidance for clinicians with less expertise in dystonia, a group of Italian Movement Disorder experts formulated clinical diagnostic recommendations for cervical, oromandibular, and limb dystonia. Methods: A panel of four neurologists generated a list of clinical items related to the motor phenomenology of the examined focal dystonias and a list of clinical features characterizing neurological/non-neurological conditions mimicking dystonia. Thereafter, ten additional expert neurologists assessed the diagnostic relevance of the selected features and the content validity ratio was calculated. The clinical features reaching a content validity ratio > 0.5 contributed to the final recommendations. Results: The recommendations retained patterned and repetitive movements/postures as the core feature of dystonia in different body parts. If present, a sensory trick confirmed diagnosis of dystonia. In the patients who did not manifest sensory trick, active exclusion of clinical features related to conditions mimicking dystonia (features that would be expected to be absent in dystonia) would be necessary for dystonia to be diagnosed. Discussion: Although reliability, sensitivity, and specificity of the recommendations are yet to be demonstrated, information from the present study would hopefully facilitate diagnostic approach to focal dystonias in the clinical practice and would be the basis for future validated diagnostic guidelines.
- Subjects :
- congenital, hereditary, and neonatal diseases and abnormalities
medicine.medical_specialty
Neurology
Pseudodystonia
Blepharospasm
Dermatology
Limb dystonia
Neurologist
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Diagnosis
otorhinolaryngologic diseases
medicine
Movement Disorder
Humans
Neurologists
030212 general & internal medicine
Sensory trick
Expert Testimony
Laryngeal dystonia
Torticollis
Neuroradiology
Dystonia
Movement Disorders
business.industry
General Medicine
Focal dystonia
Dystonic Disorder
Dystonic Disorders
Italy
2708
Neurology (clinical)
Psychiatry and Mental Health
medicine.disease
nervous system diseases
Settore MED/26 - NEUROLOGIA
Psychiatry and Mental health
diagnosis
focal dystonia
pseudodystonia
neurology (clinical)
psychiatry and mental health
medicine.symptom
business
030217 neurology & neurosurgery
Diagnosi
Human
Subjects
Details
- ISSN :
- 15903478 and 15901874
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Neurological Sciences
- Accession number :
- edsair.doi.dedup.....bfa0916ed8a4388310da62fceb46c15f