Tardive cervical dystonia

Tardive cervical dystonia (CD) is a frequent presentation of tardive syndromes, but it has not been extensively studied. We aimed to assess the clinical features of tardive CD and compared them with other tardive phenomena and idiopathic CD. Among 72 consecutive patients with tardive syndromes, CD was identified in 27 (37.5%) cases. Patients with tardive CD were younger and had a more severe clinical presentation with higher AIMS scores (P < 0.001). They also had more frequently associated comorbid facial/trunk dystonia and akathisia (P < 0.005) compared with other patients with tardive phenomena. Furthermore, patients with tardive CD were younger than those with idiopathic CD and had more phasic CD, retrocollis (head extension), facial/trunk dystonia, oro-bucco-lingual dyskinesia, limb chorea/stereotypies, akathisia, and parkinsonism (P < 0.005). No differences were observed in the severity of head deviation in any axis. Sustained CD, torticollis (head rotation), laterocollis (head tilt), alleviating maneuvers, restricted range of head motion, head tremor, and family history of CD were more common in patients with idiopathic CD compared to those with tardive CD (P ≤ 0.001). CD is observed in 37.5% of patients with tardive syndrome. In contrast to idiopathic CD, tardive CD tends to occur in younger individuals with phasic dystonia, retrocollis, and is typically associated with a variety of other hyperkinetic movement disorders.