NASA Courses for doctors

Courses
Movement Disorders

Axis II: Aetiology
Botulinum Toxin Treatment
Phenomenology of the movement disorder(s)
SYNDROME RECOGNITION

Dystonia

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 Genetic Disorders linked to dystonia

2.2.1.3.1 DRD/Segawa's Disease: DYT/PARK-GCH1

2.2.1.3.2 Paroxysmal Dyskinesia

2.2.1.3.3 Fahr's Disease: primary familial brain calcification (PFBC)

2.2.1.3.4 Neuronal Degeneration with Brain Iron Accumulation (NBIA)

2.2.1.3.5 DYT-TOR1A

2.2.1.3.6 DYT-TUBB4 (Whispering Dystonia)

2.2.1.3.7 DYT-THAP1

2.2.1.3.8 DYT-ANO3

2.2.1.3.9 DYT-GNAL

2.2.1.3.10 DYT-ATP1A3 (Rapid-onset dystonia parkinsonism)

2.2.1.3.11 Myoclonus-Dystonia: DYT-SGCE

2.2.1.3.12 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 Botulinum Toxin Treatment

8.1 Cervical Dystonia

8.1.1 CD Summary

8.1.2 Rotation

8.1.3 Laterocollis and Laterocaput & Lateral shift

8.1.4 Retrocollis and Retrocaput

8.1.5 Backward Sagittal Shift

8.1.6 Anterocollis and Anterocaput

8.1.7 Forward Sagittal Shift

8.1.8 With tremor

8.1.9 Muscles for Injection

8.1.9.1 Anterior

8.1.9.1.1 Longus capitis

8.1.9.1.2 Longus colli

8.1.9.2 Superficial

8.1.9.2.1 SCM

8.1.9.2.2 Trapezius

8.1.9.3 Intermediate

8.1.9.3.1 Levator scapulae

8.1.9.3.2 Scalenus anterior, posterior & medial

8.1.9.3.3 Splenius capitis

8.1.9.3.4 Splenius cervicis

8.1.9.4 Deep

8.1.9.4.1 Obliquus capitis inferior

8.1.9.4.2 Longissimus capitis

8.1.9.4.3 Longissimus cervicis

8.1.9.4.4 Rectus capitis posterior major

8.1.9.4.5 Semispinalis cervicis

8.1.9.4.6 Semispinalis capitis

8.2 Oromandibular Dystonia

8.2.1 Blepharospasm

8.2.2 Jaw opening dystonia

8.2.3 Jaw closing dystonia

8.2.4 Lingual dystonia

8.2.5 Jaw excursion (forward, retraction lateral)

8.2.6 Spasmodic Dysphonia

8.3 Frontalis Test for toxin resistance

Normal brain MRI or generalised atrophy

Progressive dystonia with normal brain MRI or generalised atrophy

References