Torsion dystonia
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Synopsis
With progression, these disorders can result in fixed postures with difficulty moving the affected body parts and severe limitation of function. Associated signs and symptoms may include dysarthria, dysphagia, hyperreflexia, joint contractures, and tremors. The condition can occur sporadically or be inherited, most often in an autosomal dominant manner. There are over 20 known genetic mutations identified as causes of dystonia, each with variable onset, associated symptoms, and prognoses. Some of the most notable disorders are:
- DYT1 (Oppenheim dystonia): Autosomal dominant, early onset (before age 40), typically affecting one limb first and spreading to other sites.
- DYT5 (Dopa-responsive dystonia): Autosomal dominant, childhood onset (before age 16), symptoms typically start in the leg, diurnal variation in symptoms (worse at night), associated parkinsonism, marked improvement with low-dose levodopa.
- DYT6: Autosomal dominant, child and adult onset, typically starts in the arm or cranial region, and involvement usually remains in the upper body.
- DYT11 (Myoclonus dystonia): Autosomal dominant, typically affects the upper body and spares the legs.
- DYT12 (Rapid-onset dystonia-parkinsonism): Autosomal dominant, adolescent and adult onset, parkinsonism present, dystonia generalizes over hours to weeks and then plateaus, involvement of speech.
Codes
ICD10CM:G24.1 – Genetic torsion dystonia
G24.2 – Idiopathic nonfamilial dystonia
G24.8 – Other dystonia
SNOMEDCT:
431034009 – Torsion dystonia
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Differential Diagnosis & Pitfalls
- Wilson disease
- Parkinson disease
- Huntington disease
- Corticobasal syndrome
- Perinatal cerebral anoxia, cerebral palsy
- Spinocerebellar ataxia
- Psychogenic causes
- Pelizaeus-Merzbacher disease
- Carbon monoxide poisoning
- Manganese poisoning
- Methanol poisoning
- Fahr disease
- Neuroacanthocytosis
- Leigh disease
- Neurodegeneration with brain iron accumulation
- Drug-induced dystonia
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Last Reviewed:01/30/2019
Last Updated:07/30/2020
Last Updated:07/30/2020