Title

Relative risk of spread of symptoms among the focal onset primary dystonias.

Document Type

Article

Abstract

Adult-onset primary torsion dystonia (PTD) may spread to multiple body parts, but the relative risk of spread by site of onset of dystonia has not been well characterized. We retrospectively identified 602 patients with PTD out of 1,500 dystonia patients in our electronic database and extracted age at onset, site of onset, family history, and spread. Survival analyses were performed for groups based on site of onset, and hazard ratios compared relative risk of spread across groups. Patients with adult-onset blepharospasm were more likely to spread (31% past the head) than those with dystonia starting in the neck (9%), larynx (12%), or upper extremities (16%). Hazard ratios proved that the blepharospasm group had the greatest relative risk of spread. The rate of spread after onset varied significantly between the different groups. Most spread occurred in the first 1 to 2 years after onset of blepharospasm, whereas the risk of spread was relatively constant over time in cervical and laryngeal dystonia. Different sites of onset of PTD confer different risks of spread, important for clinical prognosis. Different risks of spread may provide clues about underlying pathogenesis of adult-onset primary dystonias.

Medical Subject Headings

Adult; Disease Progression; Dystonia Musculorum Deformans; Female; Humans; Male; Organ Specificity; Retrospective Studies; Risk Factors; Survival Analysis; Time Factors

Publication Date

8-1-2006

Publication Title

Movement disorders : official journal of the Movement Disorder Society

ISSN

0885-3185

Volume

21

Issue

8

First Page

1175

Last Page

1181

PubMed ID

16673404

Digital Object Identifier (DOI)

10.1002/mds.20919

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