Dystonia Rating Scale: Difference between revisions

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== Dystonia ==
== Dystonia ==
[[File:Dystonia, medically induced.jpeg|thumb|Medically induced dystonia]]
[[File:Dystonia, medically induced.jpeg|thumb|Medically induced dystonia]]
[[Dystonia]] is a movement condition in which muscles contract involuntarily, resulting in repeated or twisting motions. The disorder can affect one area of your body (focal dystonia), two or more neighbouring sections (segmental dystonia), or your entire body (global dystonia) (general dystonia).<ref>[https://www.mayoclinic.org/diseases-conditions/dystonia/symptoms-causes/syc-20350480]Dystonia definition by  Mayo clinic</ref> Rating scales aim to evaluation the severity and distribution of motor symptoms and how they affect an individuals life. and also give a reference point for post-treatment evaluations. These tools provide an objective outcome, and need be accurate and of high quality.<ref>Albanese A, Sorbo FD, Comella C, Jinnah HA, Mink JW, Post B, Vidailhet M, Volkmann J, Warner TT, Leentjens AF, Martinez‐Martin P. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/ Dystonia rating scales: critique and recommendations.] Movement Disorders. 2013 Jun 15;28(7):874-83.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/ (accessed 18.3.2023)</ref>
[[Dystonia]] is a movement condition in which muscles contract involuntarily, resulting in repeated or twisting motions. The disorder can affect one area of your body (focal dystonia), two or more neighbouring sections (segmental dystonia), or your entire body (global dystonia) (general dystonia).<ref>[https://www.mayoclinic.org/diseases-conditions/dystonia/symptoms-causes/syc-20350480]Dystonia definition by  Mayo clinic</ref> Dystonia Rating Scales (DRS) aim to evaluation the severity and distribution of motor symptoms and how they affect an individuals life. and also give a reference point for post-treatment evaluations. These tools provide an objective outcome, and need be accurate and of high quality.<ref name=":0">Albanese A, Sorbo FD, Comella C, Jinnah HA, Mink JW, Post B, Vidailhet M, Volkmann J, Warner TT, Leentjens AF, Martinez‐Martin P. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/ Dystonia rating scales: critique and recommendations.] Movement Disorders. 2013 Jun 15;28(7):874-83.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/ (accessed 18.3.2023)</ref>


== Dystonia Rating Scale ==
== Dystonia Rating Scale ==
A task force that looked into DRS advocated the use of  seven specific dystonia scales.


==== Objective ====
# One scale rating blepharospasm (BSDI),
To measure dystonia and assess the level of the problem.
# Two scales rating cervical dystonia (CDIP-58, TWSTRS),
# One scale rating blepharospasm and cervical dystonia (CDQ-24),
# Two scales rating laryngeal dystonia (VHI, VPQ)
# One scale rating generalized dystonia (FMDRS). <ref name=":0" />


==== Background ====
==== References ====
Although several rating systems have been used to measure dystonia, only a few have had their clinimetric features tested. A task group was formed by the Movement Disorders Society to assess existing dystonia grading scales and place them in a clinical and clinimetric framework.
 
=== Types of Dystonia Rating Scale ===
Classification of the rating measures applied in studies of dystonia.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/bin/NIHMS514282-supplement-Supplementary_Material.docx]Summary of Supplementary data provided by NCBI</ref>
{| class="wikitable sortable"
|+
!
= Table 1 =
Classification of the rating measures applied in studies of dystonia.
{| class="wikitable"
! colspan="1" rowspan="2" |Scales
! colspan="1" rowspan="2" |Type
! colspan="3" rowspan="1" |Criteria
! colspan="1" rowspan="2" |Qualification
|-
! colspan="1" rowspan="1" |1
! colspan="1" rowspan="1" |2
! colspan="1" rowspan="1" |3
|-
| rowspan="1" |'''Blepharospasm (involuntary movements of the eyelids)'''<ref>Titi-Lartey OA, Patel BC. [https://www.statpearls.com/articlelibrary/viewarticle/102389/ Benign essential blepharospasm]. StatPearls [Internet]. 2022 May 24. Av ailable:https://www.statpearls.com/articlelibrary/viewarticle/102389/ (accessed 17.3.2023)</ref>
|
|
|
|
|
|-
| colspan="1" rowspan="1" | •Blepharospasm Disability Index (BSDI)
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="1" rowspan="1" | •Jankovic rating scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Blepharospasm Disability Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="6" rowspan="1" |
----
|-
| rowspan="1" |'''Cervical dystonia'''
|
|
|
|
|
|-
| colspan="1" rowspan="1" | •Cervical Dystonia Impact Scale (CDIP-58)
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="1" rowspan="1" | •Functional Disability Questionnaire
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Toronto Western Spasmodic torticollis Rating Scale (TWSTRS)
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="1" rowspan="1" | •Tsui scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Modified Tsui scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Freiberg Questionnaire for Dystonia torticollis version
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Disability questionnaire for patients with cervical dystonia
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Body Concept Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Ways of Coping Checklist
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Blepharospasm/cervical dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •Craniocervical Dystonia Questionnaire (CDQ-24)
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Oromandibular dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •Oromandibular dystonia questionnaire
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Suggested
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Laryngeal dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •Unified Spasmodic Dysphonia Rating Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Voice Handicap Index (VHI)
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="1" rowspan="1" | •Voice Handicap Index 10
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Pediatric Voice Handicap Index
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Uncertain
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Pediatric Voice-Related Quality of Life
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Uncertain
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Voice-Related Quality of Life
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Vocal Performance Questionnaire (VPQ)
| colspan="1" rowspan="1" |Generic
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Arm dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •[[Arm Dystonia Disability Scale]]
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Task-specific dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •Dystonia Evaluation Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Listed
|-
| colspan="1" rowspan="1" | •Tubiana-Chamagne Score
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Writer’s Cramp Rating Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="6" rowspan="1" |
----
|-
| colspan="1" rowspan="1" |'''Generalized dystonia'''
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
| colspan="1" rowspan="1" |
|-
| colspan="1" rowspan="1" | •Global Dystonia rating Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|-
| colspan="1" rowspan="1" | •Fahn-Marsden Dystonia Rating Scale (FMDRS)
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Recommended
|-
| colspan="1" rowspan="1" | •Unified Dystonia Rating Scale
| colspan="1" rowspan="1" |Specific
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |Yes
| colspan="1" rowspan="1" |No
| colspan="1" rowspan="1" |Suggested
|}
Notes:
 
a“Specific” indicates a measure developed specifically for dystonia, “generic” indicates a measure applicable across different diseases, including dystonia;
 
bCriteria are as follows: 1 used in dystonia patients, 2 used by researchers beyond original developers, 3 successful clinimetric testing.
|}
 
==== Abbreviations ====
{| class="wikitable"
|BoNT
|botulinum neurotoxin
|-
|BSDI
|Blepharospasm Disability Index
|-
|CDIP-58
|Cervical Dystonia Impact Scale
|-
|CDQ-24
|Craniocervical Dystonia Questionnaire
|-
|FMDRS
|Fahn-Marsden Dystonia Rating Scale
|-
|HRQoL
|Health-related quality of life
|-
|TWSTRS
|Toronto Western Spasmodic torticollis Rating Scale
|-
|VHI
|Voice Handicap Index
|-
|VPQ
|Vocal Performance Questionnaire
|}
 
==== Limitations ====
Although none of the measures evaluated are acceptable or sufficient for diagnosing a specific dystonia type (e.g., certain forms of focal or generalised dystonia, paroxysmal dystonia, etc. ), they can be used to rate severity and compare patient groups. Because most dystonia scales evaluate specific body regions, they should only be used on patients who are well-defined and homogeneous. The CDQ-24, for example, has been used in individuals with segmental and generalised dystonia to assess the impact of craniocervical dystonia on quality of life. However, because this scale is exclusive to craniocervical dystonia, using it in individuals with dystonia affecting other parts of the body could lead to inaccurate results.
 
== References ==
<references />
<references />
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Neurological - Outcome Measures]]
[[Category:Neurological - Outcome Measures]]
[[Category:Neurological - Conditions]]
[[Category:Neurological - Conditions]]

Revision as of 03:12, 18 March 2023

Original Editor - Harshit Anand Top Contributors - Lucinda hampton, Harshit Anand, Kim Jackson, Vidya Acharya and Muskan Rastogi

Dystonia[edit | edit source]

Medically induced dystonia

Dystonia is a movement condition in which muscles contract involuntarily, resulting in repeated or twisting motions. The disorder can affect one area of your body (focal dystonia), two or more neighbouring sections (segmental dystonia), or your entire body (global dystonia) (general dystonia).[1] Dystonia Rating Scales (DRS) aim to evaluation the severity and distribution of motor symptoms and how they affect an individuals life. and also give a reference point for post-treatment evaluations. These tools provide an objective outcome, and need be accurate and of high quality.[2]

Dystonia Rating Scale[edit | edit source]

A task force that looked into DRS advocated the use of seven specific dystonia scales.

  1. One scale rating blepharospasm (BSDI),
  2. Two scales rating cervical dystonia (CDIP-58, TWSTRS),
  3. One scale rating blepharospasm and cervical dystonia (CDQ-24),
  4. Two scales rating laryngeal dystonia (VHI, VPQ)
  5. One scale rating generalized dystonia (FMDRS). [2]

References[edit | edit source]

  1. ↑ [1]Dystonia definition by Mayo clinic
  2. ↑ 2.0 2.1 Albanese A, Sorbo FD, Comella C, Jinnah HA, Mink JW, Post B, Vidailhet M, Volkmann J, Warner TT, Leentjens AF, Martinez‐Martin P. Dystonia rating scales: critique and recommendations. Movement Disorders. 2013 Jun 15;28(7):874-83.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207366/ (accessed 18.3.2023)
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