Hyoid muscle dystonia: A distinct focal dystonia syndrome

E. Norby, D. Orbelo, E. Strand, J. Duffy, D. Ekbom, James Howard Bower, J. Matsumoto

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Adult-onset dystonias are often segmental in distribution and preferentially affect the craniocervical muscles. Here we describe an overlooked muscle group involved in craniocervical dystonia - the hyoid muscles. Dystonia of these muscles results in anterior neck tightness, speech changes, and dysphagia. Methods: For this retrospective study we obtained a list of 55 patients who had received botulinum toxin injections into hyoid muscles between 1998 and 2013. Fifteen patients were identified to have an unusual dystonia affecting the hyoid muscles. Results: Patients presented with a triad of speech resonance changes (100%), anterior neck tightness (86.6%), and dysphagia (73.3%). Ten (66.7%) patients presented with all three symptoms, while fourteen (93.3%) had at least two. Fourteen patients (93.3%) had a concomitant dystonia affecting the face or neck and eleven (73.3%) had a sensory trick. Exam universally showed contracted hyoid muscles. Some patients had professions or hobbies requiring prolonged use of vocal muscles such as teachers, singers, and musicians. Patients were often misdiagnosed and received unnecessary treatments. Patients underwent botulinum toxin injections into various hyoid muscles with benefit in 71% of patients but adverse effects in the same proportion. Conclusions: Hyoid muscle dystonia is a previously poorly characterized focal dystonia causing the triad of speech changes, anterior neck tightness, and dysphagia. Concomitant dystonia, sensory tricks, and visualization of contracted hyoid muscles were often present. Recognition of this disease may reduce unnecessary testing and treatments, and patients may benefit from botulinum toxin injections.

Original languageEnglish (US)
Article number2745
Pages (from-to)1210-1213
Number of pages4
JournalParkinsonism and Related Disorders
Volume21
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Dystonic Disorders
Dystonia
Muscles
Botulinum Toxins
Neck
Deglutition Disorders
Injections
Hobbies
Laryngeal Muscles
Singing
Diagnostic Errors
Retrospective Studies

Keywords

  • Botulinum toxin
  • Dystonia
  • Hyoid muscles

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Norby, E., Orbelo, D., Strand, E., Duffy, J., Ekbom, D., Bower, J. H., & Matsumoto, J. (2015). Hyoid muscle dystonia: A distinct focal dystonia syndrome. Parkinsonism and Related Disorders, 21(10), 1210-1213. [2745]. https://doi.org/10.1016/j.parkreldis.2015.08.022

Hyoid muscle dystonia : A distinct focal dystonia syndrome. / Norby, E.; Orbelo, D.; Strand, E.; Duffy, J.; Ekbom, D.; Bower, James Howard; Matsumoto, J.

In: Parkinsonism and Related Disorders, Vol. 21, No. 10, 2745, 01.10.2015, p. 1210-1213.

Research output: Contribution to journalArticle

Norby, E, Orbelo, D, Strand, E, Duffy, J, Ekbom, D, Bower, JH & Matsumoto, J 2015, 'Hyoid muscle dystonia: A distinct focal dystonia syndrome', Parkinsonism and Related Disorders, vol. 21, no. 10, 2745, pp. 1210-1213. https://doi.org/10.1016/j.parkreldis.2015.08.022
Norby, E. ; Orbelo, D. ; Strand, E. ; Duffy, J. ; Ekbom, D. ; Bower, James Howard ; Matsumoto, J. / Hyoid muscle dystonia : A distinct focal dystonia syndrome. In: Parkinsonism and Related Disorders. 2015 ; Vol. 21, No. 10. pp. 1210-1213.
@article{3dea5e1192c64eb5a10e08ec4f2cf318,
title = "Hyoid muscle dystonia: A distinct focal dystonia syndrome",
abstract = "Introduction: Adult-onset dystonias are often segmental in distribution and preferentially affect the craniocervical muscles. Here we describe an overlooked muscle group involved in craniocervical dystonia - the hyoid muscles. Dystonia of these muscles results in anterior neck tightness, speech changes, and dysphagia. Methods: For this retrospective study we obtained a list of 55 patients who had received botulinum toxin injections into hyoid muscles between 1998 and 2013. Fifteen patients were identified to have an unusual dystonia affecting the hyoid muscles. Results: Patients presented with a triad of speech resonance changes (100{\%}), anterior neck tightness (86.6{\%}), and dysphagia (73.3{\%}). Ten (66.7{\%}) patients presented with all three symptoms, while fourteen (93.3{\%}) had at least two. Fourteen patients (93.3{\%}) had a concomitant dystonia affecting the face or neck and eleven (73.3{\%}) had a sensory trick. Exam universally showed contracted hyoid muscles. Some patients had professions or hobbies requiring prolonged use of vocal muscles such as teachers, singers, and musicians. Patients were often misdiagnosed and received unnecessary treatments. Patients underwent botulinum toxin injections into various hyoid muscles with benefit in 71{\%} of patients but adverse effects in the same proportion. Conclusions: Hyoid muscle dystonia is a previously poorly characterized focal dystonia causing the triad of speech changes, anterior neck tightness, and dysphagia. Concomitant dystonia, sensory tricks, and visualization of contracted hyoid muscles were often present. Recognition of this disease may reduce unnecessary testing and treatments, and patients may benefit from botulinum toxin injections.",
keywords = "Botulinum toxin, Dystonia, Hyoid muscles",
author = "E. Norby and D. Orbelo and E. Strand and J. Duffy and D. Ekbom and Bower, {James Howard} and J. Matsumoto",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.parkreldis.2015.08.022",
language = "English (US)",
volume = "21",
pages = "1210--1213",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",
number = "10",

}

TY - JOUR

T1 - Hyoid muscle dystonia

T2 - A distinct focal dystonia syndrome

AU - Norby, E.

AU - Orbelo, D.

AU - Strand, E.

AU - Duffy, J.

AU - Ekbom, D.

AU - Bower, James Howard

AU - Matsumoto, J.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Introduction: Adult-onset dystonias are often segmental in distribution and preferentially affect the craniocervical muscles. Here we describe an overlooked muscle group involved in craniocervical dystonia - the hyoid muscles. Dystonia of these muscles results in anterior neck tightness, speech changes, and dysphagia. Methods: For this retrospective study we obtained a list of 55 patients who had received botulinum toxin injections into hyoid muscles between 1998 and 2013. Fifteen patients were identified to have an unusual dystonia affecting the hyoid muscles. Results: Patients presented with a triad of speech resonance changes (100%), anterior neck tightness (86.6%), and dysphagia (73.3%). Ten (66.7%) patients presented with all three symptoms, while fourteen (93.3%) had at least two. Fourteen patients (93.3%) had a concomitant dystonia affecting the face or neck and eleven (73.3%) had a sensory trick. Exam universally showed contracted hyoid muscles. Some patients had professions or hobbies requiring prolonged use of vocal muscles such as teachers, singers, and musicians. Patients were often misdiagnosed and received unnecessary treatments. Patients underwent botulinum toxin injections into various hyoid muscles with benefit in 71% of patients but adverse effects in the same proportion. Conclusions: Hyoid muscle dystonia is a previously poorly characterized focal dystonia causing the triad of speech changes, anterior neck tightness, and dysphagia. Concomitant dystonia, sensory tricks, and visualization of contracted hyoid muscles were often present. Recognition of this disease may reduce unnecessary testing and treatments, and patients may benefit from botulinum toxin injections.

AB - Introduction: Adult-onset dystonias are often segmental in distribution and preferentially affect the craniocervical muscles. Here we describe an overlooked muscle group involved in craniocervical dystonia - the hyoid muscles. Dystonia of these muscles results in anterior neck tightness, speech changes, and dysphagia. Methods: For this retrospective study we obtained a list of 55 patients who had received botulinum toxin injections into hyoid muscles between 1998 and 2013. Fifteen patients were identified to have an unusual dystonia affecting the hyoid muscles. Results: Patients presented with a triad of speech resonance changes (100%), anterior neck tightness (86.6%), and dysphagia (73.3%). Ten (66.7%) patients presented with all three symptoms, while fourteen (93.3%) had at least two. Fourteen patients (93.3%) had a concomitant dystonia affecting the face or neck and eleven (73.3%) had a sensory trick. Exam universally showed contracted hyoid muscles. Some patients had professions or hobbies requiring prolonged use of vocal muscles such as teachers, singers, and musicians. Patients were often misdiagnosed and received unnecessary treatments. Patients underwent botulinum toxin injections into various hyoid muscles with benefit in 71% of patients but adverse effects in the same proportion. Conclusions: Hyoid muscle dystonia is a previously poorly characterized focal dystonia causing the triad of speech changes, anterior neck tightness, and dysphagia. Concomitant dystonia, sensory tricks, and visualization of contracted hyoid muscles were often present. Recognition of this disease may reduce unnecessary testing and treatments, and patients may benefit from botulinum toxin injections.

KW - Botulinum toxin

KW - Dystonia

KW - Hyoid muscles

UR - http://www.scopus.com/inward/record.url?scp=84942192633&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942192633&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2015.08.022

DO - 10.1016/j.parkreldis.2015.08.022

M3 - Article

C2 - 26324211

AN - SCOPUS:84942192633

VL - 21

SP - 1210

EP - 1213

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

IS - 10

M1 - 2745

ER -