Clinical characteristics |
Age of onset | Infancy: birth to 2 years |
Childhood: 3 to 12 years |
Adolescence: 13 to 20 years |
Early adulthood: 21 to 40 years |
Late adulthood: >40 years |
Body distribution | Focal: involving a single body region |
Segmental: involving two or more contiguous body regions |
Multifocal: involving two noncontiguous or more (noncontiguous or not) body regions |
Generalized: involving the trunk and at least two other sites |
Hemidystonia: involving more regions restricted to one body side |
Temporal pattern | Disease course: |
Static |
Progressive |
Variability: |
Persistent: dystonia that persists to approximately the same extent throughout the day |
Action-specific: dystonia that occurs only during a particular activity or task |
Diurnal: dystonia fluctuates during the day, with recognizable circadian variations in occurrence, severity, and phenomenology |
Paroxysmal: sudden self-limited episodes of dystonia usually induced by a trigger with return to preexisting neurologic state |
Associated features | Isolated or combined with another movement disorder: |
Isolated: dystonia is the only motor feature, with the exception of tremor |
Combined: dystonia is combined with other movement disorders (such as myoclonus, parkinsonism, etc) |
Occurrence of other neurologic or systemic manifestations |
Etiology |
Nervous system pathology | Evidence of degeneration (progressive structural abnormality, such as neuronal loss) |
Evidence of structural (often static) lesions |
No evidence of degeneration or structural lesion |
Inherited or acquired | Inherited (dystonia forms of proven genetic origin): |
Autosomal dominant |
Autosomal recessive |
X-linked recessive |
Mitochondrial |
Acquired (dystonia due to a known specific cause): |
Cerebrovascular (infarction or hemorrhage) |
Perinatal brain injury |
Traumatic brain injury |
Infection |
Drug |
Toxic |
Neoplastic |
Psychogenic |
Idiopathic (unknown cause) | Sporadic |
Familial |