Objective: To study the frequency, types, phenomenology and effectiveness of sensory tricks in primary blepharospasm and cervical dystonia patients.

Background: Sensory tricks or geste antagoniste are manoeuvres seen in patients of dystonia used to temporarily reduce the severity of dystonic postures.1 Frequency of sensory tricks has been described as ranging from 17-89% in various types of dystonia.2

Methods: Our cross sectional study analysed the frequency, types, phenomenology and effectiveness of sensory tricks in 20 patients of primary blepharospasm and 20 patients of cervical dystonia. Patients underwent clinical examination using appropriate dystonia severity scales (Jankoic scale for blepharospasm, Toronto Western Spasmodic Torticollis Rating scale for cervical dystonia and Burke Fahn Marsden scale for both with eyes and neck components).

Results: Eighteen blepharospasm patients and seven cervical dystonia patients used sensory tricks to alleviate their dystonic movements. The number of blepharospasm patients using sensory tricks were significantly higher than the cervical dystonia group (p<0.05). The age group of cervical dystonia presenting with sensory tricks was significantly lower than that of those of blepharospasm with sensory tricks (p<0.05). Majority of the blepharospasm (61.1%) and cervical dystonia (42.9%) patients using sensory tricks had partial benefit (<50%) with these manoeuvres. The sensory tricks, when used, were effective everytime in 72.2% blepharospasm and 85.8% cervical dystonia patients. Sensory tricks were more commonly seen in complex cervical dystonia patients. We did not find any correlation between the presence of sensory tricks and the severity of dystonia, duration of disease, gender and education status.

Conclusions: Our study shows that sensory tricks were more common in blepharospasm patients than cervical dystonia patients. Cervical dystonia patients with sensory trick were younger than blepharospasm patients with sensory tricks. References: 1. A. Poisson, P. Krack ,S. Thobois, C. Loiraud, G. Serra, C. Vial, E. Broussolle. History of the ‘geste antagoniste’ sign in cervical dystonia. J Neurol (2012) 259:1580–1584. 2. Muller J, Wissel J, Masuhr F, Ebersbach G, Wenning GK, Poewe W. Clinical characteristics of the geste antagoniste in cervical dystonia. J Neurol 2001; 248:478–82.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sensory-tricks-in-primary-blepharospasm-and-cervical-dystonia/