Abstract
Dystonia is a common disorder of movement and tone, characterised by sustained or intermittent muscle contractions causing abnormal movements, postures or both. Children and young people with dystonia can experience episodes of acute worsening tone, which require prompt treatment. When most severe, dystonia may become life-threatening—a state called ‘status dystonicus’. This guide aims to provide a framework for how to approach the child with acutely worsening dystonia, following an ‘ABCD’ approach: Addressing the precipitant, Beginning supportive care, Calibrating sedation and Dystonia-specific medications.