Classification of dystonia in childhood

•Dystonia in childhood is a highly heterogenous condition.•The 2013 Consensus Classification system can be applied to children and young people.•Classification of 145 children resulted in 43 unique categorical groupings.•Cluster analysis following classification identified 4 major biological plausible subgroupings.

ObjectiveThe most recent international consensus update on dystonia classification proposed a system based on 2 axes, clinical characteristics and aetiology. We aimed to apply this system to Children and Young People (CAYP) selected for movement disorder surgery, and determine if meaningful groupings of cases could be extracted.MethodsThe 2013 Consensus Committee classification system for dystonia was retrospectively applied to 145 CAYP with dystonic movement disorders. Two-step cluster analysis was applied to the resulting categorisations to identify groupings of CAYP with similar characteristics.ResultsClassification resulted in a total of 43 unique groupings of categorisation. Cluster analysis detected 4 main clusters of CAYP, comparable to previously used patient groupings.ConclusionsThe 2013 consensus update on dystonia classification can be applied to CAYP with dystonia. The large number of categories provides a wealth of information for the clinician, and also facilitates data driven grouping into clinically meaningful subgroups.