The prognosis of fixed dystonia

A follow-up study

Norlinah Mohamed Ibrahim, D. Martino, B. P C van de Warrenburg, N. P. Quinn, K. P. Bhatia, R. J. Brown, M. Trimble, A. Schrag

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: The syndrome of fixed dystonia includes both CRPS-dystonia and psychogenic dystonia. The underlying mechanisms are unclear, but a high prevalence of neuropsychiatric illness has previously been reported. Methods: Clinical and neuropsychiatric follow-up study by telephone and self-administered instruments (HADS, SDQ-20, DES II, EQ-5D), on 41 patients with fixed dystonia after a mean of 7.6 (±3.6) years. Results: We obtained information on clinical outcome in 35 (85.4%) patients and neuropsychiatric questionnaire data in 22 (53.7%). Eighty-three percent were women. Thirty-one percent had worsened, 46% were the same and 23% had improved, of whom 6% had major remissions. At follow-up, mean duration of illness was 11.8 (±4.9) years and mean age 43.2 (±14.8) years. Except for 1 patient who was re-diagnosed with corticobasal degeneration, the diagnosis remained unchanged in others. Forty-one percent had scores indicating anxiety and 18% indicating depression; 18% scored within the range of dissociative/somatoform disorders on DES II and 19% on SDQ-20. The mean EQ-5D index and VAS scores were 0.34 and 56.1%. Comparison between the 3 outcome groups revealed significant difference only in the EQ-5D (p = 0.003). Only baseline CRPS predicted a worse outcome (χ2 = 0.006). Conclusions: Our findings revealed that the prognosis of this syndrome is poor, with improvement in less than 25% of patients, major remission in only 6% and continued worsening in a third. A high rate of neuropsychiatric findings was noted and new neuropsychiatric features had occurred in some. Average health status was poor. Of the baseline parameters, only CRPS predicted poorer outcome.

Original languageEnglish
Pages (from-to)592-597
Number of pages6
JournalParkinsonism and Related Disorders
Volume15
Issue number8
DOIs
Publication statusPublished - Sep 2009

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Dystonia
Dissociative Disorders
Dystonic Disorders
Somatoform Disorders
Telephone
Health Status
Anxiety
Depression

Keywords

  • Complex regional pain syndrome
  • CRPS
  • Fixed dystonia
  • Prognosis
  • Psychogenic dystonia

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Mohamed Ibrahim, N., Martino, D., van de Warrenburg, B. P. C., Quinn, N. P., Bhatia, K. P., Brown, R. J., ... Schrag, A. (2009). The prognosis of fixed dystonia: A follow-up study. Parkinsonism and Related Disorders, 15(8), 592-597. https://doi.org/10.1016/j.parkreldis.2009.02.010

The prognosis of fixed dystonia : A follow-up study. / Mohamed Ibrahim, Norlinah; Martino, D.; van de Warrenburg, B. P C; Quinn, N. P.; Bhatia, K. P.; Brown, R. J.; Trimble, M.; Schrag, A.

In: Parkinsonism and Related Disorders, Vol. 15, No. 8, 09.2009, p. 592-597.

Research output: Contribution to journalArticle

Mohamed Ibrahim, N, Martino, D, van de Warrenburg, BPC, Quinn, NP, Bhatia, KP, Brown, RJ, Trimble, M & Schrag, A 2009, 'The prognosis of fixed dystonia: A follow-up study', Parkinsonism and Related Disorders, vol. 15, no. 8, pp. 592-597. https://doi.org/10.1016/j.parkreldis.2009.02.010
Mohamed Ibrahim N, Martino D, van de Warrenburg BPC, Quinn NP, Bhatia KP, Brown RJ et al. The prognosis of fixed dystonia: A follow-up study. Parkinsonism and Related Disorders. 2009 Sep;15(8):592-597. https://doi.org/10.1016/j.parkreldis.2009.02.010
Mohamed Ibrahim, Norlinah ; Martino, D. ; van de Warrenburg, B. P C ; Quinn, N. P. ; Bhatia, K. P. ; Brown, R. J. ; Trimble, M. ; Schrag, A. / The prognosis of fixed dystonia : A follow-up study. In: Parkinsonism and Related Disorders. 2009 ; Vol. 15, No. 8. pp. 592-597.
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