Classification of Dystonia.

Lazzaro Di Biase,Vincenzo Di Lazzaro,Pasquale Maria Pecoraro,Maria Letizia Caminiti,Alessandro Di Santo

doi:10.3390/life12020206

Lazzaro Di Biase, Vincenzo Di Lazzaro + Show 3 more

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https://doi.org/10.3390/life12020206

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Abstract

Dystonia is a hyperkinetic movement disorder characterized by abnormal movement or posture caused by excessive muscle contraction. Because of its wide clinical spectrum, dystonia is often underdiagnosed or misdiagnosed. In clinical practice, dystonia could often present in association with other movement disorders. An accurate physical examination is essential to describe the correct phenomenology. To help clinicians reaching the proper diagnosis, several classifications of dystonia have been proposed. The current classification consists of axis I, clinical characteristics, and axis II, etiology. Through the application of this classification system, movement disorder specialists could attempt to correctly characterize dystonia and guide patients to the most effective treatment. The aim of this article is to describe the phenomenological spectrum of dystonia, the last approved dystonia classification, and new emerging knowledge.

Highlights

Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movement or posture
Dystonia is a hyperkinetic movement disorder characterized by abnormal movement or posture caused by excessive muscle contraction
The aim of the present review is to describe the phenomenological spectrum of dystonia and to discuss the current classification

Summary

Introduction

Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions causing abnormal movement or posture. Dystonia has distinct clinical features; a wide spectrum of phenomenological presentations may be recognized. Dystonia can present in isolation or in combination with other movement disorders like chorea, myoclonus, tremor, and parkinsonism [1]. Dystonia is one of the most underdiagnosed and misdiagnosed movement disorders. The most common misdiagnosis is between [2]: dystonic tremor and essential tremor, parkinsonian tremor, or psychogenic tremor; dystonic jerks and myoclonus; tic-like dystonia and Tourette syndrome. The first classification of dystonia was presented in 1976 [3], and during subsequent years it was modified several times [4,5,6]. The last classification was proposed in 2013 and distinguishes two main axes: axis 1, clinical characteristics, and axis 2, etiology [1]. The classification of dystonia in a single patient should be considered as a dynamic process, subject to re-evaluation in the light of the progression of clinical history and new advances in dystonia research

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