Dystonia Rating Scale

Original Editor - Harshit Anand Top Contributors - Harshit Anand, Kim Jackson and Muskan Rastogi

Dystonia[edit | edit source]

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 Scale[edit | edit source]

Objective[edit | edit source]

To measure dystonia and assess the level of the problem.

Background[edit | edit source]

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[2][edit | edit source]

Classification of the rating measures applied in studies of dystonia.

Table 1[edit | edit source]

Classification of the rating measures applied in studies of dystonia.

Scales Type Criteria Qualification
1 2 3
Blepharospasm
 •Blepharospasm Disability Index (BSDI) Specific Yes Yes Yes Recommended
 •Jankovic rating scale Specific Yes Yes No Suggested
 •Blepharospasm Disability Scale Specific Yes Yes No Suggested

Cervical dystonia
 •Cervical Dystonia Impact Scale (CDIP-58) Specific Yes Yes Yes Recommended
 •Functional Disability Questionnaire Specific Yes Yes No Suggested
 •Toronto Western Spasmodic torticollis Rating Scale (TWSTRS) Specific Yes Yes Yes Recommended
 •Tsui scale Specific Yes Yes No Suggested
 •Modified Tsui scale Specific Yes No No Listed
 •Freiberg Questionnaire for Dystonia torticollis version Specific Yes No No Listed
 •Disability questionnaire for patients with cervical dystonia Specific Yes No No Listed
 •Body Concept Scale Specific Yes No Yes Suggested
 •Ways of Coping Checklist Generic Yes No No Listed

Blepharospasm/cervical dystonia
 •Craniocervical Dystonia Questionnaire (CDQ-24) Specific Yes Yes Yes Recommended

Oromandibular dystonia
 •Oromandibular dystonia questionnaire Specific Yes No Yes Suggested

Laryngeal dystonia
 •Unified Spasmodic Dysphonia Rating Scale Specific Yes Yes No Suggested
 •Voice Handicap Index (VHI) Generic Yes Yes Yes Recommended
 •Voice Handicap Index 10 Generic Yes Yes No Suggested
 •Pediatric Voice Handicap Index Generic Uncertain Yes No Listed
 •Pediatric Voice-Related Quality of Life Generic Uncertain Yes No Listed
 •Voice-Related Quality of Life Generic Yes Yes No Suggested
 •Vocal Performance Questionnaire (VPQ) Generic Yes Yes Yes Recommended

Arm dystonia
 •Arm Dystonia Disability Scale Specific Yes Yes No Suggested

Task-specific dystonia
 •Dystonia Evaluation Scale Specific Yes No No Listed
 •Tubiana-Chamagne Score Specific Yes Yes No Suggested
 •Writer’s Cramp Rating Scale Specific Yes Yes No Suggested

Generalized dystonia
 •Global Dystonia rating Scale Specific Yes Yes No Suggested
 •Fahn-Marsden Dystonia Rating Scale (FMDRS) Specific Yes Yes Yes Recommended
 •Unified Dystonia Rating Scale Specific Yes Yes No 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[edit | edit source]

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[edit | edit source]

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[edit | edit source]

  1. [1]Dystonia definition by Mayo clinic
  2. [2]Summary of Supplementary data provided by NCBI