Objective: To describe three clinically diverse cases of dystonia managed at a Nigerian tertiary hospital and present findings from a five-year retrospective review of dystonia cases seen at the Medical Outpatient Department of the University of Nigeria Teaching Hospital (UNTH), highlighting diagnostic approaches, therapeutic interventions, epidemiological patterns, and resource-related challenges.

Background: Dystonias are a heterogeneous group of movement disorders characterized by sustained or intermittent muscle contractions that produce abnormal, often repetitive movements or postures. In sub-Saharan Africa, dystonia is frequently underdiagnosed and suboptimally managed because of limited clinician awareness, inadequate diagnostic resources, and restricted access to specialized care.

Method: Three patients with dystonia managed at UNTH were described to illustrate different clinical presentations. In addition, a retrospective review of patients diagnosed with dystonia at the Medical Outpatient Department between 2020 and 2025 was conducted. Clinical records were reviewed and demographic, clinical, and treatment data were analyzed descriptively.

Results: The case series included: (1) a 54-year-old man with idiopathic familial generalized dystonia and coexisting thoracolumbar spondylosis; (2) a 21-year-old man who developed acute drug-induced cervical dystonia following antimalarial administration; and (3) a 69-year-old man with long-standing writer’s cramp. The retrospective review identified 17 patients with dystonia. Most were male (64.7%), predominantly Igbo (94.1%), and mainly aged 18–65 years. Generalized dystonia was the most common subtype (47.1%). Trihexyphenidyl was the most frequently prescribed medication. Follow-up continuity was poor, with 70.6% of patients lost to follow-up.

Conclusion: These cases and the five-year review highlight the spectrum of dystonia encountered in a Nigerian tertiary hospital and underscore significant limitations in diagnostic capacity, therapeutic options, and long-term follow-up in low-resource settings. Improving clinician awareness, expanding access to neuroimaging and pharmacologic therapy, and establishing specialized movement disorder services are essential to improve patient outcomes.

References: 1. Albanese A, Lalli S. Update on dystonia. Curr Opin Neurol. 2012;25(4):483-90.
2. Defazio G, Abbruzzese G, Girlanda P, et al. Epidemiology of primary dystonia. Lancet Neurol. 2004;3(11):673-8.
3. Osuntokun BO, Bademosi O, Sijoore IA. Neurological disorders in Nigeria. Afr J Neurol Sci. 1987;6:27-32.
4. Jinnah HA, Factor SA. Diagnosis and treatment of dystonia. Neurol Clin. 2015;33(1):77-100.
5. Simpson DM, Blitzer A, Brashear A, et al. Assessment and treatment recommendations for cervical dystonia. Neurology. 2008;70(22):2008-14.
6. Moro E, Gross RE, Krauss JK. What’s new in surgical treatment for dystonia? Mov Disord. 2017;32(7):1033-41.
7. Olagunju AT, et al. Drug-induced movement disorders in Nigeria: A clinical review. Niger J Med. 2010;19(1):90-4.
8. Oladipo O, et al. Neurological manifestations of Wilson disease in sub-Saharan Africa. Trop Doct. 2020;50(4):278-82.
9. Okubadejo NU, et al. Movement disorders in Lagos, Nigeria: Pattern and challenges. Niger Postgrad Med J. 2021;28(2):71-6.
10. Hallett M. Neurophysiology of dystonia: The role of inhibition. Neurobiol Dis. 2011;42(2):177-84.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dystonias-in-a-nigerian-tertiary-hospital-a-case-series-highlighting-diagnostic-and-therapeutic-challenges-and-a-five-year-retrospective-review/