BACKGROUND: Dystonia is a neurologic disorder that interferes with normal motor control, causing development of bizarre postures and writhing, twisting movements. METHODS: The patient database of the Duke Movement Disorders Clinic was searched to identify and characterize all cases of dystonia evaluated during the 3 1/2 year period between July 1995 and December 1998. RESULTS: Of the 68 patients identified, 44% had focal dystonia, 10% segmental dystonia, 9% hemidystonia, 7% generalized dystonia, 4% multifocal dystonia, 12% psychogenic dystonia, and 9% tardive dystonia. The remainder had either paroxysmal or pseudodystonia. Twenty-five patients had improvement with botulinum toxin injections, 16 with anticholinergics, benzodiazepines and/or baclofen, and 2 with tetrabenazine. CONCLUSION: A variety of treatments can give symptomatic benefit in dystonia, but appropriate treatment requires proper diagnosis of the condition.