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NEUROLOGY 1997;48:732-735
© 1997 American Academy of Neurology

Treatment of putative immune-mediated and idiopathic cervical dystonia with intravenous methylprednisolone

Rajeev Kumar, MD, Demetrius M. Maraganore, MD, J. Eric Ahlskog, PhD, MD and Moses Rodriguez, MD

From the Department of Neurology, Mayo Clinic, Rochester, MN.
Presented in part at the 47th annual meeting of the American Academy of Neurology, Seattle, WA, May 1995.
Received March 26, 1996. Accepted in final format September 13, 1996.
Address correspondence and reprint requests to Dr Maraganore, Dept. of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Article abstract-A young pregnant woman developed a persistent dystonic head tremor a few days after Rho (D)-immune globulin administration; further deterioration occurred after a second administration of Rho (D) immune globulin with the development of marked retrocollis. This persisted and she was treated 2 months later with a 5-day course of intravenous (1 g daily) methylprednisolone (IVMP) with resolution of her condition. We proceeded to treat similarly the next four patients with idiopathic cervical dystonia who were seen in our practice and who had current symptoms of less than 6 months duration. One also experienced persistent resolution and another had a marked, but transient, improvement after each of two separate courses of IVMP. The other two patients did not have improvement. This suggests a possible autoimmune pathogenesis for a limited subset of cervical dystonia. However, identifying which cases of recent-onset cervical dystonia will respond to IVMP therapy has yet to be determined.

NEUROLOGY 1997;48: 732-735






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