Geste antagoniste in dystonia: Demystifying the tricks

Sensory tricks, also known as “geste antagoniste” or “alleviating maneuvers,” refer to specific maneuvers that temporarily improve dystonic postures; this is often considered to be a hallmark of primary dystonia. Although classically described to be simple activities such as a gentle touch, they can be complex and multisensory, including tactile, proprioceptive, visual, auditory, and thermal stimuli or even imaginary tricks. To date, there is no concrete concept to explain the mechanisms by which geste antagoniste alleviate dystonia. The suggested mechanisms imply an increase in intracortical facilitation in dystonia, and balance between facilitation and inhibition is restored by the geste. This narrative review aims to provide a brief overview of geste antagoniste, covering the historical aspects, types of geste, known mechanisms, and implications.