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 |
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