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Table 3 Practical guideline in evaluation of patients with LCrD

From: The phenomenology and natural history of idiopathic lower cranial dystonia

History
Onset
Description of the abnormal movement or sensation
Precipitating factor (especially history of recent dental work or maxillofacial trauma) lower cranial
Aggravating and relieving factors
Associated symptoms such as pain, jaw clicking
Sensory tricks
History of previous treatment such as dental prosthesis
History of secondary causes of dystonia especially dopamine receptor blocking agent exposure
Examination
Identify the primary movement(s)
  o Jaw in each axis: opening/closing, lateral deviation (left/right), protrusion/retraction
  o Tongue: protrusion/retraction, torsion
Determine task specificity (dystonia occurs with speaking, eating/chewing and/or at rest)
Identify sensory tricks: light touch, placing objects such as plastic syringe or tongue depressor between teeth on each side and in the center
Assess evidence of dystonia in other body parts especially in upper cranial region, voice and neck
  1. Legend: Practical guideline in history taking and physical examination of patients with LCrD is described.