Document Detail


Treatment of focal dystonia.
MedLine Citation:
PMID:  22415705     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Dystonia is characterized by repetitive twisting movements or abnormal postures due to involuntary muscle activity. When limited to a single body region it is called focal dystonia. Examples of focal dystonia include cervical dystonia (neck), blepharospasm (eyes), oromandibular dystonia, focal limb dystonia, and spasmodic dysphonia, which are discussed here. Once the diagnosis is established, the therapeutic plan is discussed with the patients. They are informed that there is no cure for dystonia and treatment is symptomatic. The main therapeutic option for treating focal dystonias is botulinum toxin (BoNT). There have been several attempts to characterize the procedure, the type of toxin, dosage, techniques, and combination with physical measures in each of the focal dystonia forms. The general treatment principles are similar. The affected muscles are injected at muscle sites based on evidence and experience using standard dosages based on the type of toxin used. The injections are repeated after 3 to 6 months based on the individual response duration. In the uncommon event of nonresponse with BoNT, the dose and site are reassessed. Oral drug treatment could be considered as an additional option. Once the condition is thought to be medically refractory, the opinion from the deep brain stimulation (DBS) team for the suitability of the patient for DBS is taken. The successful use of DBS in cervical dystonia has led to increased acceptance for trial in other forms of focal dystonias. DBS surgery in focal dystonias other than cervical is, however, still experimental. The patients may be offered the surgery with adequate explanation of the risks and benefits. Patient education and directing the patients towards dystonia support groups and relevant websites that provide scientific information may be useful for long-term compliance and benefit.
Authors:
Amit Batla; Maria Stamelou; Kailash P Bhatia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in neurology     Volume:  14     ISSN:  1534-3138     ISO Abbreviation:  Curr Treat Options Neurol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-22     Completed Date:  2012-10-02     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  9815940     Medline TA:  Curr Treat Options Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  213-29     Citation Subset:  -    
Affiliation:
The National Hospital for Neurology and Neurosurgery Queen Square, Box 13, London, WC1N 3BG, UK.
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
089698//Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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