• Neepa Patel, John Hanfelt, Laura Marsh, Joseph Jankovic, and members of the Dystonia Coalition.
• Department of Neurology and Neurotherapeutics, Center for Movement Disorders, University of Texas Southwestern, Dallas, Texas, USA.
• J. Neurol. Neurosurg. Psychiatr.. 2014 Aug 1;85(8):882-4.

BackgroundThere is limited information on the phenomenology, clinical characteristics and pathophysiology of alleviating manoeuvres (AM), also called 'sensory tricks' in cervical dystonia (CD).MethodsIndividual data, collected from 10 sites participating in the Dystonia Coalition (http://clinicaltrials.gov/show/NCT01373424), included description of localisation and phenomenology of AM collected by systematic review of standardised video examinations. Analyses correlated demographic, neurologic, and psychiatric features of CD patients with or without effective AM.ResultsOf 154 people studied, 138 (89.6%) used AM, of which 60 (43.4%) reported partial improvement, 55 (39.8%) marked improvement, and 4 (0.03%) no effect on dystonic posture. Light touch, usually to the lower face or neck, was used by >90%. The presence or location of AM did not correlate with the severity of the dystonia.ConclusionsIn this large and comprehensive study of CD, we found no clinical predictors of effective AM. Further studies of sensorimotor integration in dystonia are needed to better understand the pathophysiology of AM.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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