Clinical spectrum of focal dystonias: Experience from a tertiary care center
BACKGROUND: There is a paucity of literature in patients with focal dystonia from our country with certain differences in the clinical characteristics as compared to the Western population. OBJECTIVES: The aim of this study was to evaluate the clinical spectrum of patients with focal dystonia attend...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Annals of Movement Disorders |
| Subjects: | |
| Online Access: | http://www.aomd.in/article.asp?issn=2590-3446;year=2020;volume=3;issue=2;spage=99;epage=105;aulast=Prasad |
| _version_ | 1818259630391820288 |
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| author | Rupesh Prasad Deepika Joshi Vijay N Mishra Rameshwar N Chaurasia Abhishek Pathak |
| author_facet | Rupesh Prasad Deepika Joshi Vijay N Mishra Rameshwar N Chaurasia Abhishek Pathak |
| author_sort | Rupesh Prasad |
| collection | DOAJ |
| description | BACKGROUND: There is a paucity of literature in patients with focal dystonia from our country with certain differences in the clinical characteristics as compared to the Western population. OBJECTIVES: The aim of this study was to evaluate the clinical spectrum of patients with focal dystonia attending the neurology outpatient department and of admitted patients in neurology ward of a tertiary care hospital. MATERIALS AND METHODS: All consecutive patients of focal dystonia from October 2017 to September 2019, fulfilling the inclusion criteria were enrolled. Patients were subjected to a detailed history and thorough examination as per a predesigned pro forma. RESULTS: Of a total of 88 patients with focal dystonia, 62.5% were male. Majority of the focal dystonia (51.1%) had late adulthood onset (>40 years). Writer’s cramp was the most common type of focal dystonia (n = 38; 43.2%), but in patients older than 40 years, focal cranial dystonias (n = 28 of 43, 65.1%) were the most common. Oromandibular dystonia and blepharospasm had significantly older mean age of onset compared to focal upper limb (57.0 ± 14.05, 44.9 ± 13.83 vs. 31.5 ± 17.67; P < 0.001, P = 0.032, respectively). Most of the focal dystonias were isolated (87.5%, n = 77) and idiopathic (66%). Among the acquired causes, drugs were the most common (n = 9; 10.1%), followed by perinatal birth insult (n = 4; 4.5%). All of the drug-induced focal dystonias were oromandibular. CONCLUSION: Focal dystonia was more prevalent in males, and it had an earlier age of onset by a decade as compared to the Western population. Writer’s cramp was the most common type of focal dystonia, but in patients older than 40 years, cranial dystonias were the most common. In patients presenting with oromandibular dystonia, a drug history should be carefully sought. |
| first_indexed | 2024-12-12T18:18:30Z |
| format | Article |
| id | doaj.art-6b7a3d0d57ad4c40bde1b5f5f67261c5 |
| institution | Directory Open Access Journal |
| issn | 2590-3446 2590-3454 |
| language | English |
| last_indexed | 2024-12-12T18:18:30Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Movement Disorders |
| spelling | doaj.art-6b7a3d0d57ad4c40bde1b5f5f67261c52022-12-22T00:16:13ZengWolters Kluwer Medknow PublicationsAnnals of Movement Disorders2590-34462590-34542020-01-01329910510.4103/AOMD.AOMD_14_20Clinical spectrum of focal dystonias: Experience from a tertiary care centerRupesh PrasadDeepika JoshiVijay N MishraRameshwar N ChaurasiaAbhishek PathakBACKGROUND: There is a paucity of literature in patients with focal dystonia from our country with certain differences in the clinical characteristics as compared to the Western population. OBJECTIVES: The aim of this study was to evaluate the clinical spectrum of patients with focal dystonia attending the neurology outpatient department and of admitted patients in neurology ward of a tertiary care hospital. MATERIALS AND METHODS: All consecutive patients of focal dystonia from October 2017 to September 2019, fulfilling the inclusion criteria were enrolled. Patients were subjected to a detailed history and thorough examination as per a predesigned pro forma. RESULTS: Of a total of 88 patients with focal dystonia, 62.5% were male. Majority of the focal dystonia (51.1%) had late adulthood onset (>40 years). Writer’s cramp was the most common type of focal dystonia (n = 38; 43.2%), but in patients older than 40 years, focal cranial dystonias (n = 28 of 43, 65.1%) were the most common. Oromandibular dystonia and blepharospasm had significantly older mean age of onset compared to focal upper limb (57.0 ± 14.05, 44.9 ± 13.83 vs. 31.5 ± 17.67; P < 0.001, P = 0.032, respectively). Most of the focal dystonias were isolated (87.5%, n = 77) and idiopathic (66%). Among the acquired causes, drugs were the most common (n = 9; 10.1%), followed by perinatal birth insult (n = 4; 4.5%). All of the drug-induced focal dystonias were oromandibular. CONCLUSION: Focal dystonia was more prevalent in males, and it had an earlier age of onset by a decade as compared to the Western population. Writer’s cramp was the most common type of focal dystonia, but in patients older than 40 years, cranial dystonias were the most common. In patients presenting with oromandibular dystonia, a drug history should be carefully sought.http://www.aomd.in/article.asp?issn=2590-3446;year=2020;volume=3;issue=2;spage=99;epage=105;aulast=Prasadcranial dystoniadrug-induced dystoniafocal dystoniaoromandibular dystoniawriter’s cramp |
| spellingShingle | Rupesh Prasad Deepika Joshi Vijay N Mishra Rameshwar N Chaurasia Abhishek Pathak Clinical spectrum of focal dystonias: Experience from a tertiary care center Annals of Movement Disorders cranial dystonia drug-induced dystonia focal dystonia oromandibular dystonia writer’s cramp |
| title | Clinical spectrum of focal dystonias: Experience from a tertiary care center |
| title_full | Clinical spectrum of focal dystonias: Experience from a tertiary care center |
| title_fullStr | Clinical spectrum of focal dystonias: Experience from a tertiary care center |
| title_full_unstemmed | Clinical spectrum of focal dystonias: Experience from a tertiary care center |
| title_short | Clinical spectrum of focal dystonias: Experience from a tertiary care center |
| title_sort | clinical spectrum of focal dystonias experience from a tertiary care center |
| topic | cranial dystonia drug-induced dystonia focal dystonia oromandibular dystonia writer’s cramp |
| url | http://www.aomd.in/article.asp?issn=2590-3446;year=2020;volume=3;issue=2;spage=99;epage=105;aulast=Prasad |
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