Nonmotor symptoms and focal cervical dystonia: Observations from 102 patients

Introduction: Evidence is emerging that nonmotor symptoms (NMS) such as neuropsychiatric, sensory and sleep disturbances play an important role in dystonia. Methods: In this observation, 102 patients with cervical dystonia (CD) were included. We evaluated the complaints about NMS with an adapted NMS Questionnaire and motor severity measured with Unified Dystonia Rating Scale. Results: 95% of CD patients experienced NMS with 36% presenting with at least seven NMS. Mean UDRS score was 5.09 points (standard deviation (SD) +/- 2.64 points, range 0.5-14.0). 42% patients had additional head tremor. The total number of experienced NMS was not significantly correlated with the age of the patients and disease duration of dystonia. There was also no significant association between number of NMS and sex. The correlation between number of NMS and motor severity assessed with UDRS was weak (rS = 0.23; p = 0.02). Conclusion: The number of NMS as a whole has been shown to be a key determinant of health related quality of live in patients with Parkinson's disease and we would assume that can influence this construct in patients with dystonia, too. As 95% of our patients with focal CD present with NMS, especially loss of self- confidence, insomnia, fatigue and pain, higher awareness for NMS needs to be raised in the context of routine clinical consultations in patients with focal dystonia. (C) 2014 Elsevier GmbH. All rights reserved.