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Clinical Management of Dystonia in Childhood

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Abstract

Dystonia is one of the most frequent movement disorders in childhood. It can impede normal motor development and cause significant motor disability. The diagnostic evaluation of childhood dystonia is challenging due to the phenotypic variability and heterogeneous etiologies. Evidence to guide the diagnostic evaluation and treatment is limited. Assessment is primarily directed by clinical history and distinctive examination findings. Neuroimaging is typically necessary to evaluate for acquired or complex inherited dystonias. A trial of levodopa can be both diagnostic and therapeutic in children with dopa-responsive dystonia. However, for the majority of children with early-onset dystonia, treatment is symptomatic with varying efficacy. There is a paucity of therapeutic trials for childhood dystonia and most treatment recommendations are consensus or expert opinion driven. This review summarizes the available evidence and guidelines on the diagnostic evaluation and pharmacological treatment of childhood-onset dystonia and provides practical frameworks to approach both issues based on best evidence.

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Acknowledgments

The authors thank Genevieve Santillanes at the University of Southern California for her assistance in editing the manuscript.

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Authors and Affiliations

  1. Pediatric Movement Disorders Program, Children’s Hospital Los Angeles, University of Southern California, 4650 Sunset Blvd., Mailstop 82, Los Angeles, CA, USA

    Quyen N. Luc

  2. Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA

    Jyes Querubin

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  1. Quyen N. Luc
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  2. Jyes Querubin
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Correspondence to Quyen N. Luc.

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Drs Luc and Querubin have no conflicts of interest.

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Luc, Q.N., Querubin, J. Clinical Management of Dystonia in Childhood. Pediatr Drugs 19, 447–461 (2017). https://doi.org/10.1007/s40272-017-0243-3

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