A Novel Presentation of an Ocular Geste Antagoniste in Cervical Dystonia: A Case Report

  • James T Boyd
  • Timothy J Fries
  • Keith J Nagle
  • Robert W. Hamill

Abstract

Background: A geste antagoniste or sensory trick is a well described phenomenon associated with primary cervical dystonia. Craniocervical tactile stimulation or stereotyped limb movements allow patients to transiently ameliorate dystonic activation of cervical musculature.

Case Report: We report a patient with primary cervical dystonia who presented with a novel “ocular” geste antagoniste. Through a sensory trick of tonic left eye deviation, the patient transiently reduces cervical dystonic activity (improved range of motion and reduced dystonic tremor). Multi‐channel surface electromyography and video are used to illustrate these findings.

Discussion: This case presents a unique clinical observation of specific voluntary eye movements attenuating cervical dystonia. The phenomenon is phenotypically consistent with previously described limb sensorimotor tricks.