Volume 18, Issue 6 p. 706-711
Brief Report with Video

Unusual phenotypes in DYT1 dystonia: A report of five cases and a review of the literature

Mark Edwards MRCP

Mark Edwards MRCP

Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, United Kingdom

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Nicholas Wood PhD

Nicholas Wood PhD

Department of Neurogenetics, Institute of Neurology, Queen Square, London, United Kingdom

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Kailash Bhatia FRCP

Corresponding Author

Kailash Bhatia FRCP

Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, United Kingdom

Reader in Neurology, Sobell Department of Movement Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London WC1N 3BG, United KingdomSearch for more papers by this author
First published: 28 May 2003
Citations: 65

A videotape accompanies this article.

Abstract

Since the advent of widespread testing for the presence of the DYT1 gene mutation, the range of phenotypes that have been associated with this genetic abnormality has expanded. We report on 5 DYT1 gene-positive patients with unusual phenotypes. Two of them had late presentation, one of these after peripheral injury. Three additional patients had late progression of symptoms, onset after exposure to haloperidol, and severe bulbar involvement, respectively. The clinical heterogeneity of this condition raises problems for clinicians in selecting appropriate patients for diagnostic testing. Also, because of the low phenotypic penetrance of DYT1 dystonia, the discovery of the DYT1 mutation in a patient with an atypical clinical syndrome may not necessarily suggest a causal relationship. We have, therefore, analysed all published clinical studies of DYT1 dystonia to guide clinical decision making concerning DYT1 gene testing based on current information. © 2003 Movement Disorder Society