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 |