ABSTRACT.One hundred and ten of 117 infants of birth weight less than 1500g managed at the Mater Mothers' Hospital were followed during the first year of life. A severe behavioural disturbance with minor neurological signs was identified in 12 (13%) babies assessed at 1 month of age. At 4 months, 18 (17%) babies exhibited features suggestive of the dystonic syndrome. The 18 dystonic infants sustained more perinatal asphyxia and apnoea and were more likely to be ventilated, compared with the 89 non‐dystonic infants examined at 4 months. The dystonic infants had lower General Quotient scores at all ages. By 8 to 12 months of age, features of the dystonic syndrome had resolved in 13 (72%) of these babies. Five of the infants identified as dystonic at 4 months had major neurological and/or intellectual handicap at 1 year of age. Caution must be exercised when counselling the parents of infants with the dystonic syndrome. The role of intervention programmes of physiotherapy in the dystonic infants and the long term outlook of these babies needs further evaluatio