Status dystonicus: Predictors of outcome and progression patterns of underlying disease

Abstract

The course and outcome of SD is highly variable; male gender and prevalent tonic phenotype predict a poor outcome.

Indwelling intrathecal catheter with subcutaneous abdominal reservoir: a viable baclofen delivery system in severely cachectic patients

“…15 Precipitating causes include infection, 29,30 medication change, 29,43 and surgery, 33,47 so careful thought should be given to minimizing these factors in patients with dystonia. As with dyskinetic CP, response to oral drugs is generally poor, with one series reporting that just 10.1% of patients responded to treatment.…”

“…As with dyskinetic CP, response to oral drugs is generally poor, with one series reporting that just 10.1% of patients responded to treatment. 15 Tetrabenazine and benzhexol may be efficacious, but the majority of patients who receive these drugs require sedation and further intervention. 15,29 Previous reports have found ITB to be efficacious in this setting, 18,30,33 but evidence to the contrary also exists.…”

“…15 Tetrabenazine and benzhexol may be efficacious, but the majority of patients who receive these drugs require sedation and further intervention. 15,29 Previous reports have found ITB to be efficacious in this setting, 18,30,33 but evidence to the contrary also exists. 29 Narayan et al have described postoperative SD in an adolescent with CP who required muscle paralysis and ventilatory support.…”

“…Alternatives to treat SD include DBS, which has replaced older lesional procedures such as thalamotomy and pallidotomy. 7 Deep brain stimulation appears to be particularly effective for treating SD, 9,15,25,30,47 but the risks of brain surgery may preclude surgeons from utilizing it as a first-line intervention. In routine settings, the hardware failure rate may be as high as 15%, 12 and it can be even higher in patients with SD.…”

Dystonia Severity Action Plan: a simple grading system for medical severity of status dystonicus and life‐threatening dystonia

“…Early recognition may potentially facilitate intervention and prevent progression. In a recently reported large retrospective case series of 89 episodes of status dystonicus 4 (58.8% occurring in children <15y) first-line pharmacological treatments of established status dystonicus (most commonly anticholinergics and tetrabenazine) were effective in~10% of cases. Treatment in this case series frequently necessitated deep sedation in intensive care and there carried a mortality rate of 10.3%.…”