Dystonia.

Objective: This article focuses on the epidemiology, diagnostic criteria, and clinical features of dystonia. The treatment of dystonia and controversies in the field are also addressed.

Latest developments: The latest international classification is in development to further refine diagnostic criteria for dystonia. This emphasis on classification highlights the importance of accurately recognizing clinical signs in a disorder requiring a diagnosis without a clear biomarker. Accurate workup and diagnosis facilitate appropriate treatment. The field of dystonia therapy now includes both neurostimulation and an expanding number of botulinum toxin options for the treatment of focal dystonia. Nonmotor symptoms of dystonia, including pain, mood disorders, and sleep disruption, have also been gaining recognition. Screening and treatment for these symptoms are becoming increasingly important.

Essential points: Dystonia is a variable movement disorder that can present as the sole motor manifestation of a disease or as a symptom within another disease process (ie, Parkinson disease). Swift recognition of the signs and symptoms of dystonia is the key to the clinical diagnosis and initiating appropriate treatment.