Table 1.
Dystonia classification | Main dystonic phenotype | Gene | Inheritance | Locus | Other common clinical presentations/ additional clinical features |
---|---|---|---|---|---|
Combined dystonia | Dopa-responsive dystonia-parkinsonism | DDC | AR | None | DD, oculogyric crisis, truncal hypotonia, dysautonomia, ptosis |
DNAJC12 | AR | None | DD, intellectual disability, HPA | ||
GCH1 | AD and AR | DYT5 | DD, hypotonia, spasticity and HPA in in bi-allelic mutation carriers | ||
PTS | AR | None | DD, oculogyric crisis, truncal hypotonia, dysautonomia, seizures, HPA | ||
QDPR | AR | None | DD, oculogyric crisis, truncal hypotonia, dysautonomia, seizures, HPA | ||
SLC18A2 | AR | None | DD, truncal hypotonia, dysautonomia | ||
SLC6A3 | AR | None | DD, oculogyric crisis, truncal hypotonia, bulbar dysfunction | ||
SPR | AR | None | DD, oculogyric crisis, truncal hypotonia, dysautonomia | ||
TH | AR | DYT5b | DD, oculogyric crisis, truncal hypotonia, dysautonomia, ptosis | ||
Dystonia-chorea-myoclonus | ADCY5 | AD and AR | None | Episodic hyperkinesias triggered by sleep, truncal hypotonia | |
Generalized dystonia with prominent cranial involvement | KMT2B | AD | DYT28 | Intellectual disability, short stature | |
Myoclonus-dystonia | KCTD17 | AD | DYT26 | Mild motor DD | |
SGCE | AD | DYT11 | Psychiatric co-morbidities (anxiety, obsessive compulsive disorder, alcohol addiction) | ||
Generalized dystonia with prominent laryngeal dystonia | TUBB4A | AD | DYT4 | Hypomyelination with atrophy of basal ganglia and cerebellum (H-ABC) | |
Generalized dystonia-parkinsonism | PRKRA | AR | DYT16 | None | |
Rapid-onset dystonia parkinsonism | ATP1A3 | AD | DYT12 | Alternating hemiplegia of childhood, Cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome, paroxysmal limb dystonia | |
Isolated dystonia | Adult-onset cranio-cervical dystonia | ANO3 | AD | DYT24 | Subcortical myoclonus, prominent dystonic tremor |
GNAL | AD and AR | DYT25 | None | ||
Early-onset generalized dystonia | HPCA | AR | DYT2 | Learning disabilities, DD | |
THAP1 | AD and AR | DYT6 | None | ||
TOR1A | AD | DYT1 | Severe arthrogryposis in bi-allelic mutation carriers | ||
Paroxysmal dystonia | Paroxysmal exercise-induced dystonia | SLC2A1 | AD | DYT9 or DYT18 | GLUT1-deficiency syndrome (DD, spasticity, microcephaly, ataxia, epilepsy) |
Paroxysmal kinesigenic dystonia | KCNA1 | AD | n/a | Paroxysmal ataxia with interictal myokymia | |
PRRT2 | AD | DYT10 or DTY19 | Benign familial infantile epilepsy, hemiplegic migraine, paroxysmal torticollis of infancy | ||
SCN8A | AD | None | Benign familial infantile seizures, early infantile epileptic encephalopathy | ||
Paroxysmal non-kinesigenic dystonia | KCNMA1 | AD | None | Epilepsy, DD, cerebellar ataxia | |
PNKD | AD | DYT8 | None | ||
Paroxysmal torticollis of infancy | CACNA1A | AD | None | Paroxysmal ataxia with interictal dystonia, hemiplegic migraine, SCA6, early infantile epileptic encephalopathy |
Genes have been grouped by their overall dystonia classification and main dystonic phenotype. Within these groupings, genes are sorted alphabetically. AD = autosomal dominant; AR = autosomal recessive; DD = developmental delay; HPA = hyperphenylalanaemia; SCA = spinocerebellar ataxia.