title: How long does it take to diagnose cervical dystonia?
abstract: BACKGROUND
  Dystonia is a neurological disorder characterized by involuntary twisting movements and postures. The neck is among the most commonly affected regions, and diagnosis can be made readily through a simple clinical evaluation. The goal of this study was to explore how long it took patients to receive a diagnosis of cervical dystonia after symptom onset.
  
  
  METHODS
  A structured questionnaire was administered at outpatient clinics of a tertiary care academic medical center to 146 consecutively evaluated patients. The questionnaire addressed the length of time from symptom onset to diagnosis, the numbers and types of providers seen before reaching a diagnosis, and treatments attempted prior to receiving botulinum toxin.
  
  
  RESULTS
  A total of 108 patients saw a mean of 3.5 providers over a mean period of 44 months from symptom onset to diagnosis. For patients with symptom onset in the last decade only, patients saw a mean of 3.0 providers over a mean of 14 months.
  
  
  CONCLUSIONS
  Although cervical dystonia is the most common form of dystonia with clinical features readily identifiable by a simple history and examination, patients typically see multiple providers over more than a year before reaching a diagnosis and receiving optimal therapy. Improved awareness of the clinical features will enable patients to obtain appropriate therapy more rapidly.
authors.affiliation: Department of Neurology, Emory University, Atlanta GA, 30322 USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Tiderington
authors.forename: Emily M
authors.initials: EM
authors.lastname: Goodman
authors.forename: Ami R
authors.initials: AR
authors.lastname: Rosen
authors.forename: Edie R
authors.initials: ER
authors.lastname: Hapner
authors.forename: Michael M
authors.initials: MM
authors.lastname: Johns
authors.forename: Marian L
authors.initials: ML
authors.lastname: Evatt
authors.forename: Alan
authors.initials: A
authors.lastname: Freeman
authors.forename: Stewart
authors.initials: S
authors.lastname: Factor
authors.forename: H A
authors.initials: HA
authors.lastname: Jinnah
mesh_terms: D000328:Adult; D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013997:Time Factors; D014103:Torticollis / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins
keywords: Cervical dystonia; Cohort studies; Diagnosis; Dystonia; Movement disorder; Torticollis
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