“…In most neurology subspecialty practices, the vast majority of patients with dystonia are adults with primary focal or segmental disease. Genetic factors likely play a major role in late-onset primary dystonia since 8–27% of patients with primary late-onset dystonia have one or more family members affected with dystonia [ 5 - 9 ] and several of the primary dystonias inherited in Mendelian fashion (DYT1, DYT5, DYT6, DYT11, and DYT12) begin focally, show incomplete penetrance and exhibit variable anatomical expressivity [ 10 - 12 ]. These facts suggest that sporadic late-onset dystonia, much like Parkinson's disease, is a complex disorder with contributions from multiple genes and environmental factors.…”