In any child with generalized dystonia that fluctuates dramatically throughout the day, perform a levodopa trial before extensive workup because dopa-responsive dystonia is treatable with low doses and is frequently missed. When botulinum toxin is planned for a focal dystonia, set expectations correctly—efficacy for craniocervical sites is high but limb dystonia responds less reliably.

Features a childhood or young adult onset; Clinicians currently recognize approximately thirteen distinct types of inherited dystonia; Second axis is by etiology, splitting cases into primary forms—which often feature a childhood or adolescent onset—and secondary forms driven by specific hereditary syndromes or environmental injuries; Two main clinical categories that fall under this heading are primary generalized dystonia and primary focal dystonia; This extensive list includes highly unique entities like dopa-responsive dystonia as well as various forms of paroxysmal dyskinesias