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Adult-onset Idiopathic Focal Lower Extremity Dystonia: A Rare Task-Specific Dystonia Cover

Adult-onset Idiopathic Focal Lower Extremity Dystonia: A Rare Task-Specific Dystonia

Open Access
|Jan 2013

Figures & Tables

Table 1.

Mount Sinai Case Series

Patient #Age/SexOnset AgeDuration (yrs)LimbPrecipitant Movement TaskPhenomenologyPresent at RestOther Limbs AffectedFHMedicationsResponse
131/M265RWalking down stepsPlantarflexes foot and flexes hip when walking down steps. Absent while walking up steps or backward.NoNonePDSinemetNone
224/F204LMarathon runningInversion and plantarflexion of the foot while walking that becomes more prominent with running. Does not occur when walking backward.NoNoneNoneSinemetNone
333/F312RMarathon runningSustained inversion while walking, which normalizes while walking backward. Improves with side stepping in either direction as well as walking forward while imagining walking backward.NoNoneNoneSinemet Artane Baclofen BTX to calf ValiumNone None None None Yes
460/F582LDistance walkingHip flexion with slight side to side lurch while walking. Improves with imagined walking backward while walking forward.NoNoneMother & Father - PDKlonopin ArtaneNone None
561/M583RWalkingEversion of foot while walking on cobblestone terrain or walking down steps. Disappears while walking on flat surfaces, running, or climbing stairs.NoNoneMother - similar movementsSinemetNone
627/F225LDistance runningInversion and sustained plantarflexion of the foot while walking. Movements disappeared while walking backward ,as well as imagined walking backward while walking forward. No abnormal movements when climbing stairs or during side stepping.NoNoneNoneArtaneNone
780/M782RWalkingEversion of foot while walking that disappears while walking backward or sideways and climbing stairs.NoYes - R Wrist 'Yips'NoneSinemetNone
853/F494LWalkingCurling of toes and inversion of foot while walking, which is also produced with foot tapping.NoNoneNoneBTX Klonopin GabapentinYes Yes Yes
975/F696RWalkingHyperextension and abduction of leg. More prominent with speed walking.NoNoneNoneSinemet RopineroleNone None
Mean49.345.63.7
Table 2.

Focal Task-Specific Lower Extremity Dystonia Comparative Analysis

No.MFMF(yrs)RLBoth
Singer and Papapetropoulus44131359.5x0400/42
Schneider et al.51761151148.2PD - 1 LD -2 Hand Tremor - 17812/15 (arm, cervical dystonia)NR
Wu and Jankovic65232337.401400/50
McKeon et al.73653101451.1NRNRNRNR0/144
MSMC9363645.7PD - 2 LD - 15401/9(yips)0
Total71</emph>17</emph>54</emph>11</emph>3748.38132016

Abbreviations: (FH, Family History; PF, Plantarflexion; DF, Dorsiflexion; (+), presence; (−), absence; NR, not reported; PD, Parkinson1s Disease; LD, Limb dystonia; BTX, Botulinum Toxin; MSMC, Mount Sinai Medical Centre).

Video.

Patient 1 has Right Hip Flexion while Walking Down Steps.

Video.

Patient 2 Exhibits Right Foot Inversion while Walking Forward.

Video.

Patient 3 has Inversion and Sustained Plantar Flexion of the Left Foot while Walking Forward.

Video.

Patient 4 has Inversion of the Left Foot with Toe Curling while Walking Forward.

DOI: https://doi.org/10.5334/tohm.135 | Journal eISSN: 2160-8288
Language: English
Submitted on: Oct 23, 2012
Accepted on: Nov 26, 2012
Published on: Jan 22, 2013
Published by: Columbia University Libraries/Information Services
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2013 Ritesh A. Ramdhani, Steven J. Frucht, published by Columbia University Libraries/Information Services
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.