Journal article
Segmental and Multifocal Isolated Dystonias: Similarities and Differences
Movement disorders clinical practice (Hoboken, N.J.), Vol.13(3), pp.748-756
03/2026
DOI: 10.1002/mdc3.70390
PMCID: PMC13042789
PMID: 41074569
Abstract
Whether the traditional distinction between segmental and multifocal dystonia is clinically or scientifically useful remains unclear.
To evaluate whether idiopathic isolated adult-onset segmental and multifocal dystonia can be differentiated based on clinical features other than the contiguity of affected body regions.
We compared data on segmental and multifocal dystonia from two large dystonia databases established in the USA and Italy that used similar criteria for patient recruitment and assessment.
Compared to segmental dystonia, multifocal dystonia was characterized by a higher proportion of men, a younger age at dystonia onset, a greater frequency of upper limb dystonia, and a lower frequency of cranial dystonia at both onset and last examination. Segmental and multifocal dystonia had a similar frequency of alleviating maneuvers, non-motor eye symptoms in blepharospasm, and neck pain and tremor in cervical dystonia. Although the initial spread pattern from focal to segmental or multifocal appeared faster in the segmental dystonia group, adjusting the analysis for the initial body site involved revealed no significant differences between the two groups. Segmental and multifocal dystonia starting in the same body site showed similar age, sex, and spread characteristics. The observed differences and similarities were consistent across both independent databases.
Segmental and multifocal dystonia share differences and similarities. The observed differences may reflect a difference in the predominant site of dystonia onset. From a clinical perspective, therefore, the segmental/multifocal distinction is probably not valuable in the dystonia classification scheme, although further data may be needed from a pathophysiological perspective.
Details
- Title: Subtitle
- Segmental and Multifocal Isolated Dystonias: Similarities and Differences
- Creators
- Hyder A Jinnah - Emory UniversityVittorio Velucci - University of Bari Aldo MoroDaniele Belvisi - Istituto Neurologico MediterraneoGamze Kilic-Berkmen - Emory UniversityJoel S Perlmutter - Washington University in St. LouisLaura J Wright - Washington University in St. LouisChristine Klein - University of LübeckJeanne S Feuerstein - University of Colorado DenverSteven Bellows - Baylor College of MedicineJoseph Jankovic - Baylor College of MedicineCynthia Comella - Rush University Medical CenterRichard L Barbano - University of RochesterAparna Wagle Shukla - University of FloridaStephen G Reich - University of Maryland, BaltimoreMark S LeDoux - Texas NeurologyAlberto J Espay - University of CincinnatiKevin R Duque - University of CincinnatiFlorence C F Chang - The University of SydneyVictor S C Fung - Westmead HospitalSarah Pirio-Richardson - University of New MexicoCarmen Terranova - University of MessinaEmile S Moukheiber - Johns Hopkins UniversitySarah Idrissi - Neurology Unit, "Dimiccoli" General Hospital, Barletta, ItalyBarbara Vitucci - University of Bari Aldo MoroSusan H Fox - University of TorontoSamuel Frank - Beth Israel Deaconess Medical CenterNatividad Stover - University of Alabama at BirminghamBrian D Berman - Virginia Commonwealth UniversityRachel Saunders-Pullman - Mount Sinai Beth IsraelWilliam G Ondo - Houston MethodistChristopher L Groth - University of IowaMarcello Esposito - Ospedale Antonio CardarelliLaura Avanzino - University of GenoaFrancesco Bono - Azienda Ospedaliero Universitario Mater DominiRoberto Erro - University of SalernoMarcello Mario Mascia - University of CagliariAntonella Muroni - University of CagliariAlfredo Berardelli - Sapienza University of RomeGiovanni Defazio - University of Bari Aldo Moro
- Resource Type
- Journal article
- Publication Details
- Movement disorders clinical practice (Hoboken, N.J.), Vol.13(3), pp.748-756
- DOI
- 10.1002/mdc3.70390
- PMID
- 41074569
- PMCID
- PMC13042789
- NLM abbreviation
- Mov Disord Clin Pract
- ISSN
- 2330-1619
- eISSN
- 2330-1619
- Publisher
- Wiley
- Grant note
- Italian Parkinson's and Movement Disorders: Society/LIMPE-DISMOV (RADAC)
Data were extracted from the Dystonia Coalition and the Italian Dystonia Registry. The Italian Dystonia Registry is supported by the Italian Parkinson's and Movement Disorders Society/LIMPE-DISMOV (RADAC project). We thank all participants of the Dystonia Coalition and the Italian Dystonia Registry for their valuable contribution.
- Language
- English
- Electronic publication date
- 10/11/2025
- Date published
- 03/2026
- Academic Unit
- Neurology
- Record Identifier
- 9985014872702771
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