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) |
| Â | o Jaw in each axis: opening/closing, lateral deviation (left/right), protrusion/retraction |
| Â | 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 |