Phenomenology and classification of dystonia: A consensus update

Movement Disorders - Tập 28 Số 7 - Trang 863-873 - 2013
Alberto Albanese1,2, Kailash P. Bhatia3, Susan Bressman4, Mahlon R. DeLong5, Stanley Fahn6, Victor S.C. Fung7, Mark Hallett8, Joseph Jankovic9, Hyder A. Jinnah10, Christine Klein11, Anthony E. Lang12, Jonathan W. Mink13, Jan K. Teller14
1Department of Neurology Carlo Besta National Neurological Institute Milan Italy
2Department of NeurologyCarlo Besta National Neurological InstituteMilan Italy
3Sobell Department of Motor Neuroscience and Movement Disorders Institute of Neurology University College London (UCL) London United Kingdom
4Departments of Neurology Beth Israel Medical Center and Albert Einstein College of Medicine, New York, New York and Bronx New York USA
5Department of Neurology, Emory University, Atlanta Georgia, USA
6Department of Neurology, Columbia University, New York, New York, USA
7Movement Disorders Unit, Department of Neurology, Westmead Hospital and Sydney Medical School, University of Sydney, Sydney, Australia
8Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
9Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology Baylor College of Medicine Houston Texas USA
10Departments of Neurology, Human Genetics and Pediatrics, Emory University, Atlanta, Georgia, USA
11Section of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
12Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease Toronto Western Hospital and the University of Toronto Toronto Canada
13Departments of Neurology, Neurobiology, and Anatomy, Brain and Cognitive Sciences, and Pediatrics University of Rochester Rochester, New York USA
14Dystonia Medical Research Foundation Chicago Illinois USA

Tóm tắt

ABSTRACT

This report describes the consensus outcome of an international panel consisting of investigators with years of experience in this field that reviewed the definition and classification of dystonia. Agreement was obtained based on a consensus development methodology during 3 in‐person meetings and manuscript review by mail. Dystonia is defined as a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned and twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. Dystonia is classified along 2 axes: clinical characteristics, including age at onset, body distribution, temporal pattern and associated features (additional movement disorders or neurological features); and etiology, which includes nervous system pathology and inheritance. The clinical characteristics fall into several specific dystonia syndromes that help to guide diagnosis and treatment. We provide here a new general definition of dystonia and propose a new classification. We encourage clinicians and researchers to use these innovative definition and classification and test them in the clinical setting on a variety of patients with dystonia. © 2013 Movement Disorder Society

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