We performed a service-based epidemiological study of dystonia in Munich, Germany. Due to favourable referral and treatment patterns in the Munich area, we could provide confident data from dystonia patients seeking botulinum toxin treatment. A total of 230 patients were ascertained, of whom 188 had primary dystonia. Point prevalence ratios were estimated to be 10.1 (95% confidence interval 8.4–11.9) per 100,000 for focal and 0.3 (0.0–0.6) for generalised primary dystonia. The most common focal primary dystonias were cervical dystonia with 5.4 (4.2–6.7) and essential blepharospasm with 3.1 (2.1–4.1) per 100,000 followed by laryngeal dystonia (spasmodic dysphonia) with 1.0 (0.4–1.5) per 100,000.

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