Abstract Details

Title Features and Challenges in Runner's Dystonia

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 199

Objective

Background BACKGROUND: RD is an adult-onset dystonia triggered by long-distance running. Most reported RD cases are characterized by lower extremity dystonia. Here we review the variability in presentation, evolution and response to therapy of a large case series of RD.

Design/Methods DESIGN/METHODS: We conducted a retrospective study of patients with lower-body dystonia seen at the National Institutes of Health. Demographic, clinical and treatment characteristics were analyzed.

Results RESULTS: In 23 years, 483 patients with dystonia were evaluated, of which 35 had lower limb dystonia or camptocormia. Eight of these 35 patients had dystonia apparently triggered by running, 3 females and 5 males. All were long-distance runners who trained between 40-100 miles/week. The mean age of onset was 53.4 + 4.8 years. The mean disease duration was 5.6 + 2.7 years with no development parkinsonian symptoms. Seven had gait-motion analyses with EMG. Four had dystonia of the lower extremities, one had segmental dystonia involving the lower extremities and axial musculature, and two had purely axial involvement. Of patients with lower limb dystonia, three had proximal involvement, while two had both proximal and distal lower limb dystonia. Six reported benefit with a sensory or motor trick. Four out of five patients responded to botulinum therapy, with an average reported improvement in symptoms of 46%.

Conclusions CONCLUSIONS: This is the largest reported case series of RD. Although RD was initially described as involving only the lower extremities, our series suggests a more variable presentation. The key diagnostic feature is that initial symptoms are triggered by running in long-distance runners. Treatment of RD remains challenging, as patients may only achieve moderate benefit with botulinum injections.

Authors/Disclosures
Pritha T. Ghosh, MD (George Washington Medical Faculty Associates) PRESENTER	Dr. Ghosh has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for New Touch Digital.
	No disclosure on file
Amelia Evoli, MD (Catholic University, Neuroscience Dept)	No disclosure on file
Barbara P. Karp, MD, FAAN	Dr. Karp has nothing to disclose.
Mark Hallett, MD, FAAN (National Institutes of Health)	Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Hallett has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Brainsway. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for VoxNeuro. Dr. Hallett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for QuantalX. Dr. Hallett has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Hallett has received intellectual property interests from a discovery or technology relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Speaker with International Parkinson and Movement Disorder Society. Dr. Hallett has a non-compensated relationship as a Past-President with Functional Neurological Disorder Society that is relevant to AAN interests or activities.
Codrin I. Lungu, MD, FAAN	Dr. Lungu has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier, inc..
Katharine Alter, MD (National Institutes of Health)	Katharine Alter, MD has received personal compensation for serving as an employee of Paradigm Medical Communications. Katharine Alter, MD has received personal compensation for serving as an employee of Cleveland clinic foundation. Katharine Alter, MD has received personal compensation for serving as an employee of Catalyst medical . Katharine Alter, MD has received personal compensation for serving as an employee of AANEM. Katharine Alter, MD has received personal compensation for serving as an employee of Efficiwent CME. Katharine Alter, MD has received publishing royalties from a publication relating to health care.

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