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J Neurol Neurosurg Psychiatry. 2007 Mar;78(3):260-3. Epub 2006 Oct 20.

Head trauma in primary cranial dystonias: a multicentre case-control study.

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1
Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare, 11 70124 Bari, Italy.

Erratum in

  • J Neurol Neurosurg Psychiatry. 2007 Apr;78(4):440. Majorana, Giuseppe [corrected to Majorana, Giovanni].

Abstract

BACKGROUND:

The relationship between prior trauma and primary adult-onset dystonia is not well understood. Previous uncontrolled observations and exploratory case-control studies have yielded contradictory results.

OBJECTIVE:

To analyse the association between cranial dystonia and prior head trauma.

METHODS:

An ad hoc multicentre case-control study was performed using a semistructured interview to collect detailed information on the history of head trauma before disease onset in five Italian tertiary referral centres for movement disorders. The presence of a history of head trauma and of post-traumatic sequelae (loss of consciousness, bone fractures, scalp/facial wounds) before disease onset was recorded from 177 patients with primary adult-onset cranial dystonia and from 217 controls with primary hemifacial spasm matched by age strata and sex. Differences between groups were assessed by Mann-Whitney U test and Fisher's exact test, and the relationship between prior head trauma and case/control status was analysed by multivariate logistic regression models.

RESULTS:

No association was found between vault/maxillofacial trauma and cranial dystonia. Most reported traumas occurred several years before disease onset. None of the main post-traumatic sequelae altered the chance of developing cranial dystonia compared with patients with primary hemifacial spasm, nor did head trauma modify the age at onset of cranial dystonia.

CONCLUSIONS:

These results do not support prior head trauma as a possible environmental factor modifying the risk of developing late-onset cranial dystonia. The lack of association may have pathogenetic and medical-forensic implications.

PMID:
17056625
PMCID:
PMC2117628
DOI:
10.1136/jnnp.2006.103713
[Indexed for MEDLINE]
Free PMC Article
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