Quiz Form

Question Date: 10/08/2023

Question: An 8-year-old girl presents to the clinic with frequent falls while running. She reports that her symptoms began 3 months ago when starting soccer practice and notes that, when trying to run, her legs would get stiff and feel funny. Sometimes, she would fall when this happened. On examination, when asked to run down the hall, she develops intorsion of the left foot and significant stiffening of the right leg. She is able to run backward well<br><br>What is the most appropriate therapy at this time?

Options:

• Baclofen
• Botulinum toxin
• Levodopa
• Trihexyphenidyl

Correct Answer: Levodopa

Explaination: This patient presented with dystonia of the lower extremities induced by running. In any childhood-onset dystonia, a 1-month levodopa trial should be administered as the initial therapy, given the potential diagnosis of levodopa-responsive dystonia. Levodopa-responsive dystonia improves substantially, and may even resolve, with levodopa therapy. The other choices are all appropriate to consider in patients with various types of dystonia, but levodopa should always be tried first.

Reference: Morgante F, Klein C. Dystonia. Continuum (Minneap Minn). 2013 Oct19(5 Movement Disorders)1225-41. doi 10.121201.CON.0000436154.08791.67. PMID 24092288.