Delayed onset dystonia associated with perinatal asphyxia in two patients and asphyxia in early childhood in two patients is reported from the Neurological Institute of New York. In the perinatal group the mean age of onset was 12.9 years; dystonia progressed for a mean of 7 years and as long as 28 years. The patients had moderate motor disability and none was wheelchair bound. The prognosis was better than that of childhood onset idiopathic torsion dystonias. In the absence of any identifiable cause of dystonia the authors considered the asphyxia as related either directly or indirectly to the development of dystonia. [1]

COMMENT. Despite the known difficulties in relating adverse perinatal events to static encephalopathies of childhood, the authors claim a relationship between perinatal asphyxia and late onset dystonia based on exclusion of other cuases of dystonia and documentation by birth records or a verbal history that asphyxia occurred.