Courses
Movement Disorders
Axis II: Aetiology
Focal Dystonia and Botulinum Toxin Treatment
Phenomenology of the movement disorder(s)
SYNDROME RECOGNITION
Dystonia
INDEX
1
OVERVIEW OF DYSTONIA
2
CLASSIFICATION OF DYSTONIA
2.1
Axis I: Clinical Features
2.1.1
Age at Onset
2.1.2
Body distribution
2.1.3
Temporal Pattern
2.1.4
Associated features
2.2
Axis II: Aetiology
2.2.1
Inherited
2.2.1.1
DYT naming system for dystonia
2.2.1.2
Proposed Dystonia Naming System
2.2.1.3
Table of genes associated with dystonia
2.2.1.4
Genetic Disorders linked to dystonia
2.2.1.4.1
Wilson's Disease
2.2.1.4.2
DRD/Segawa's Disease: DYT/PARK-GCH1
2.2.1.4.3
Paroxysmal Dyskinesia & differential of paroxysmal events
2.2.1.4.4
Myoclonus-Dystonia: DYT-SGCE
2.2.1.4.5
Fahr's Disease: primary familial brain calcification (PFBC)
2.2.1.4.6
Neuronal Degeneration with Brain Iron Accumulation (NBIA)
2.2.1.4.7
DYT-TOR1A
2.2.1.4.8
DYT-TUBB4 (Whispering Dystonia)
2.2.1.4.9
DYT-THAP1
2.2.1.4.10
DYT-ANO3
2.2.1.4.11
DYT-GNAL
2.2.1.4.12
DYT-ATP1A3(Rapid-onset dystonia parkinsonism)
2.2.1.4.13
DYT-PRKRA
2.2.2
Acquired
3
EXAMINATION OF DYSTONIA
4
SYNDROME RECOGNITION
4.1
Phenomenology of the disorder(s)
4.2
Diagnostic algorithm of dystonia
4.3
Dystonia Syndromes: Red Flags
4.4
Combined Dystonia Syndromes
4.4.1
With Parkinsonism
4.4.2
With Spasticity +/- Parkinsonism
4.4.3
With cerebellar ataxia
4.4.4
With myoclonus
4.4.5
With paroxysmal dyskinesias
4.4.6
With prominent oro-mandibular involvement
4.5
With other neurological involvement
4.5.1
With ocular disorders
4.5.2
With deafness
4.5.3
With progressive dementia
4.5.4
With peripheral neuropathy
4.6
Dystonia with systemic disease
4.6.1
With endocrinological abnormalities
4.6.2
With hematological abnormalities
4.6.3
With solid organ involvement
4.7
Syndromes according to Brain Imaging
4.7.1
Neurodegeneration with brain iron accumulation (NBIA)
4.7.2
With basal ganglia lesions (other than BIA)
4.7.3
With basal ganglia calcification
4.7.4
With leukoencephalopathy
4.7.5
Normal brain MRI or generalised atrophy
5
PHYSIOLOGY OF DYSTONIA
6
RATING SCALES FOR DYSTONIA
7
MAJOR TYPES OF DYSTONIA
7.1
Primary dystonia, PD or Parkinsonian syndrome?
7.2
Dystonia in Parkinson-plus syndromes
7.3
Disorders of Posture in Parkinsonism
7.4
Dystonic Tremor
7.5
Focal lesions & Dystonia
8
Focal Dystonia and Botulinum Toxin Treatment
8.1
Cervical Dystonia (CD)
8.1.1
Torticollis & Torticaput
8.1.2
Laterocollis, Laterocaput & Lateral shift
8.1.3
Retrocollis & Retrocaput
8.1.4
Backward Sagittal Shift (Double Chin)
8.1.5
Anterocollis & Anterocaput
8.1.6
Forward (Anterior) Sagittal Shift (Goose Neck)
8.1.7
With tremor
8.1.8
Muscles for Injection
8.1.8.1
Anterior
8.1.8.1.1
Longus Colli
8.1.8.1.2
Longus Capitis
8.1.8.2
Superficial
8.1.8.2.1
Trapezius
8.1.8.2.2
SCM
8.1.8.3
Intermediate
8.1.8.3.1
Scalenus Ant Med Post
8.1.8.3.2
Levator Scapulae
8.1.8.3.3
Splenius Capitis
8.1.8.3.4
Splenius Cervicis
8.1.8.4
Deep
8.1.8.4.1
OCI
8.1.8.4.2
Semispinalis Capitis
8.1.8.4.3
Semispinalis Cervicis
8.1.8.4.4
Longissimus Capitis
8.1.8.4.5
Longissimus Cervicis
8.1.8.4.6
Rectus Capitis Posterior Major
8.1.8.4.7
OC Superior
8.1.9
Ultrasound-Anatomical correlation
8.2
Oromandibular Dystonia
8.2.1
Blepharospasm
8.2.2
Jaw closing dystonia
8.2.3
Jaw opening dystonia
8.2.4
Lingual dystonia
8.2.5
Jaw excursion (forward, retraction lateral)
8.2.6
Spasmodic Dysphonia
8.3
Focal limb dystonia
8.4
Frontalis Test for toxin resistance
Rectus Capitis Posterior Major
Origin:
posterior tubercle/spinous process of atlas (C2).
Insertion:
medial portion of occipital bone below inferior nuchal line.
Action:
extends head.
Rotates head to same side (ipsilateral rotation).
References
