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Dystonia

Jonathan Theo, DO and Erik Krause, D.O Reviewed 06/2022
 


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 typ...

DIAGNOSIS

HISTORY

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

  • Voluntary action often worsens dystonia.

  • Dystonia improves when the body ...

TREATMENT

GENERAL MEASURES

  • There is no universal treatment algorithm since there are many different subtypes.

  • Nonetheless, general management options include botulinum toxin injections, oral medications...

ONGOING CARE

PROGNOSIS

Regarding surgical outcomes  (3
  • Generally speaking patients with shorter disease duration generally do better than those with longer durations.

  • Patients with mobile dystonia do b...

REFERENCES

1
Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013;28(7):863–73.
2
Tarsy D, Simon DK. Dystonia. N Engl J Med. 2006;3...

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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