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Front. Neurol. | doi: 10.3389/fneur.2019.01081

Focal task-specific lower limb dystonia only when walking stairs: is it a new disease entity?

 JONGSAM BAIK1*, HYEO-IL MA2, PHIL HUE LEE3 and Takaomi Taira4
  • 1Inje University Sanggye Paik Hospital, South Korea
  • 2Hallym University Sacred Heart Hospital, South Korea
  • 3College of Medicine, Yonsei University, South Korea
  • 4Tokyo Women's Medical University, Japan

Introduction: Focal task-specific dystonia in the lower limb or foot are occurred only during walking, running, hiking or cycling. Several medications and botulinum toxin injection are effective in these patients. The objective of this study was to understand of the spectrum of focal task-specific dystonia in the lower limb only when walking stairs and to compare with other types of task-specific dystonia.
Methods: Using PubMed, all original articles and case reports were collected and reviewed. In addition, all video clips of published cases were evaluated, and patients’ clinical findings analyzed. The present study included 12 patients described in previous studies and five new Asian patients found in the medical records.
Results: Most of them were women, and the onset age was 42 years. Ten patients were classified as the Kicking type, including three patients with the rKicking type, and six patients were considered the Lifting type; however, only one patient was not included in any of the types. Symptoms in most of all patients did not improve with any medication or botulinum toxin injection. The symptom of the most patients was not changed over a long time.
Conclusion: Most patients showed the dystonic symptom when walking downstairs rather than upstairs. Psychogenic dystonia is a disease differentially diagnosed with this dystonia. Unlike other types of focal task-specific dystonia, the response to treatment was disappointing because most of the medications and botulinum toxin injection were not effective. The prognosis is completely different from other types of focal task-specific dystonia.

Keywords: focal dystonia, walking dystonia, task-specific, lower limb, Stairs

Received: 21 Jun 2019; Accepted: 25 Sep 2019.

Copyright: © 2019 BAIK, MA, LEE and Taira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. JONGSAM BAIK, Inje University Sanggye Paik Hospital, Seoul, South Korea, moon100@naver.com