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Short-lived Response of Cervical Dystonia to Electroconvulsive Therapy

Garcia, Rafael F. MD*; Dias, Allan G. MD*; de Freitas, Andrea R. MD; Fontenelle, Leonardo F. MD*‡

doi: 10.1097/YCT.0b013e31818b0ab1
Case Reports

Cervical dystonia (CD) or spasmodic torticollis is the most frequent form of focal dystonia. Cervical dystonia is characterized by sustained neck spasms, abnormal head posture, head tremor, and pain. A 53-year-old male patient with the diagnosis of CD developed an episode of delusional depression and was treated with electroconvulsive therapy (ECT). An unexpected and dramatic improvement of CD was seen during the first 2 days after each ECT session. That therapeutic effect was not sustained and vanished soon afterward. The effectiveness of ECT for CD, although too brief to be recommended as a useful treatment, may shed light on the pathophysiology of this problematic movement disorder.

From the *Anxiety and Depression Research Program, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil; †Service of Neurology, Universidade Federal Fluminense (MMC/UFF), Niterói, Rio de Janeiro, Brazil; and ‡Department of Psychiatry and Mental Health, Universidade Federal Fluminense (MSM/UFF), Niterói, Rio de Janeiro, Brazil.

Received for publication July 3, 2008; accepted July 25, 2008.

Reprints: Leonardo F. Fontenelle, MD, PhD, Rua Visconde de Pirajá, 547 Sala 719, Ipanema, Rio de Janeiro, Rio de Janeiro, 22410-003, Brazil (e-mail:

This work was supported by a grant from the Conselho Nacional de Desenvolvimento Científico e Tecnológico.

© 2009 Lippincott Williams & Wilkins, Inc.