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

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.