Treatment of Dystonia

Abstract

Selecting the appropriate treatment for dystonia begins with proper classification of disease based on age, distribution, and underlying etiology. The therapies available for dystonia include oral medications, botulinum toxin, and surgical procedures. Oral medications are generally reserved for generalized and segmental dystonia. Botulinum toxin revolutionized the treatment of focal dystonia when it was introduced for therapeutic purposes in the 1980s. Surgical procedures are available for medication-refractory dystonia, markedly affecting an individual's quality of life.

Neurological manifestations in Wilson’s disease –possible treatment options for symptoms

“…[9,36] This together with the severe disability typically caused by dystonia encourages the use of symptomatic treatments that are known to be effective in other neurodegenerative disorders manifested by dystonia. [24] The treatment of dystonia depends on its severity and localization. Independent of etiology, focal dystonias are usually treated with BTX injections.…”

“…[6,24,27,37] The pharmacological agents used in the treatment of dystonia include (1) anticholinergics, (2) baclofen, (3) benzodiazepines, (4) dopaminergic compounds (levodopa or dopamine agonists), (5) dopamine-depleting drugs, and (6) antiepileptic drugs (carbamazepine/oxcarbamazepine). [24,28] The data on the efficacy of this kind of treatment in patients with WD are limited but encouraging. BTX injections used in focal dystonias were effective in 8/9 patients with WD (the remaining patient had a slight improvement), as reported separately by three different centers.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Therefore, such treatments should also be considered as potentially effective in patients with WD, especially those with severe neurological presentations who are not responding to or perhaps even deteriorating while receiving anticopper therapy. However, so far only case reports have been published describing such therapy in patients with WD (Table 1).…”

Identification and management of tardive dyskinesia: A case series and literature review

“…This evidence supports the hypothesis that anticholinergic therapy in patients prone to develop TD may increase the incidence of this disorder. Some studies however have shown improvement in tardive dystonia following trihexyphenidyl treatment [46,50].…”

Editorial: Neurotherapeutics of Movement Disorders

“…The impact of surgical approaches is also examined, but the conclusion remains that there is a need for new treatments. Thenganatt and Jankovic [12] provide a comprehensive review of therapeutic approaches for dystonia discussing the standard medications, as well as outcomes of clinical trials of chemodenervation with botulinum toxins and surgical techniques. The roles of these therapeutic interventions are discussed based on a new classification of disease.…”