Table 2 Type of and times to spread according to the site of dystonia onset
Presentation of dystonia
Blepharospasm (n = 124)Cervical dystonia (n = 73)Focal hand dystonia (n = 26)
No. of patients who experienced spread of dystonia581710
Spread to eyelids
No (% vs total spread)3 (18%)2 (20%)
Years to spread (SD)10 (3.0)12 (4.2)
Spread to oromandibular region
No (% vs total spread)42 (72%)6 (35%)3 (30%)
Years to spread (SD)2.3 (2.6)5.7 (4.5)8 (3.4)
Spread to neck
No (% vs total spread)26 (45%)7 (70%)
Years to spread (SD)6.6 (7.1)7.7 (6.7)
Spread to upper limb
No (% vs total spread)2 (3.4%)10 (59%)2 (20%)
Years to spread (SD)6.5 (0.7)8.1 (6.6)4.5 (0.5)
Spread to trunk
No (% vs total spread)02 (11%)0
Years to spread (SD)4 (0.5)
  • Twelve patients starting with blepharospasm, four starting with cervical dystonia, and four starting with focal hand dystonia had spread to two body parts, the others to one body part alone. No spread to larynx was observed.