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Dystonia

Erik Krause, D.O, Annika Medhus, MD and Tran Le, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both. These movements are ty...

DIAGNOSIS

HISTORY

History of present illness (2
  • Patients often complain of abnormal head posture or movements, tremor, or myoclonus.

  • Voluntary action often triggers or worsens dystonia.

  • Dystonia improv...

TREATMENT

GENERAL MEASURES

For drug-induced dystonia cessation of the offending agent is key. 

MEDICATION

Botulinum toxin injections  (4
  • This is the treatment of choice for focal and segmental dystonia....

ONGOING CARE

PROGNOSIS

Regarding surgical outcomes, factors correlated with better outcomes include shorter disease duration, mobile dystonia vs. tonic or fixed postures, and isolated dystonia syndrom...

REFERENCES

1
Tarsy D, Simon DK. Dystonia. N Engl J Med. 2006;355(8):818–829.
2
Jinnah HA. The dystonias. Continuum (Minneap Minn). 2019;25(4):976–1000.
3
Albanese A, Bhatia K, Bressman SB, et al. Phenomeno...

CODES

CLINICAL PEARLS

  • An isolated head tremor should raise suspicion for cervical dystonia.

  • Characteristic signs of dystonia include overflow, dystonic tremor, null points, mirror movements, sensory tricks, ...

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