Evaluation and treatment of dystonia

Dystonia is a neurologic disorder that interferes with normal motor control, causing development of bizarre postures and writhing, twisting movements.

The patient database of the Duke Movement Disorders Clinic was searched to identify and characterize all cases of dystonia evaluated during the 3 1/2 year period between July 1995 and December 1998.

Of the 68 patients identified, 44% had focal dystonia, 10% segmental dystonia, 9% hemidystonia, 7% generalized dystonia, 4% multifocal dystonia, 12% psychogenic dystonia, and 9% tardive dystonia. The remainder had either paroxysmal or pseudodystonia. Twenty-five patients had improvement with botulinum toxin injections, 16 with anticholinergics, benzodiazepines and/or baclofen, and 2 with tetrabenazine.

A variety of treatments can give symptomatic benefit in dystonia, but appropriate treatment requires proper diagnosis of the condition.