Cranial dystonia

The earliest recognition of cranial dystonia, including blepharospasm and oromandibular dystonias (OMDs), might be found in the paintings of the Flemish artist Brueghel from the 16th century, who painted subjects with apparent blepharospasm and involuntary jaw opening (JO) (1). The first medical descriptions were by Talkow in Germany and Wood in the USA in 1871. In 1899, Gowers described various conditions associated with tonic and clonic contractions of the neck and jaw. Henry Meige published his landmark paper on blepharospasm and OMD in 1910, and the eponym “Meige’s syndrome” is often still used to designate idiopathic craniocervical dystonia. Various authors have ascribed eponyms to Wood, Brueghel, and Blake (an artist who also painted dystonic postures) to describe this syndrome. Marsden et al. designated blepharospasm-OMD syndrome to be a variant of adult-onset torsion dystonia (2). Although often discussed together because of many similarities, they are probably distinct enough to represent distinct neurological entities. The terms blepharospasm, OMD, and cranial dystonia (combined upper and lower facial dystonia) are used throughout the chapter.