‘‘Closing the Loop’’ in Cervical Dystonia: A New Clinical Phenomenon

Background: The sensory trick or geste antagoniste is a cardinal feature of cervical dystonia. Patients are often aware of their tricks, using them to their advantage to temporarily improve dystonic symptoms. The typical sensory trick must be internally generated by the patient in order to be effective, and external mechanical pressure alone may not be sufficient. Methods: We present a case description. We present and demonstrate a new clinical phenomenon in patients with cervical dystonia, which we call ‘‘closing the loop’’. Discussion: We discuss the possible mechanisms underlying this finding.