Treatment of Dystonia: Medications, Neurotoxins, Neuromodulation, and Rehabilitation

Bledsoe, Ian O.; Viser, Aaron C; Luciano, Marta San

doi:10.1007/s13311-020-00944-0

Cited by 25 publications

(34 citation statements)

References 241 publications

(307 reference statements)

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“…Rehabilitation with physical therapy, occupational therapy, or speech therapy is also important, depending on the dystonia subtype. 70,71 Rehabilitation can improve functional ability, prevent contractures in persistent/fixed postures through targeted splinting and specific exercises/stretching, facilitate sensorimotor retraining, and more effectively harness sensory tricks.…”

Section: Symptomatic Treatment For Dystoniamentioning

confidence: 99%

“…71 In comparison, thalamic DBS (eg, targeting the thalamic ventralis intermedius nucleus) may be more effective than GPi DBS for the treatment of dystonic tremor, and thalamic DBS also has potential efficacy in acquired dystonia and spasmodic dysphonia. 71 There are differential effects of DBS, with the best evidence of efficacy for isolated generalized dystonia (particularly DYT-TOR1A), younger age at surgery, shorter disease duration, and higher baseline severity. 71 In contrast, older age, longer duration, genetic forms that are less amenable to DBS, the presence of functional dystonia, and fixed posture/contractures portend a poor response (TABLE .…”

Section: Key Pointsmentioning

confidence: 99%

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The Dystonias

Stephen¹

2022

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW: This article discusses the most recent findings regarding the diagnosis, classification, and management of genetic and idiopathic dystonia.RECENT FINDINGS: A new approach to classifying dystonia has been created with the aim to increase the recognition and diagnosis of dystonia. Molecular biology and genetic studies have identified several genes and biological pathways involved in dystonia.SUMMARY: Dystonia is a common movement disorder involving abnormal, often twisting, postures and is a challenging condition to diagnose. The pathophysiology of dystonia involves abnormalities in brain motor networks in the context of genetic factors. Dystonia has genetic, idiopathic, and acquired forms, with a wide phenotypic spectrum, and is a common feature in complex neurologic disorders. Dystonia can be isolated or combined with another movement disorder and may be focal, segmental, multifocal, or generalized in distribution, with some forms only occurring during the performance of specific tasks (task-specific dystonia). Dystonia is classified by clinical characteristics and presumed etiology. The management of dystonia involves accurate diagnosis, followed by treatment with botulinum toxin injections, oral medications, and surgical therapies (mainly deep brain stimulation), as well as pathogenesis-directed treatments, including the prospect of disease-modifying or gene therapies.

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Section: Symptomatic Treatment For Dystoniamentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

The Dystonias

Stephen¹

2022

CONTINUUM: Lifelong Learning in Neurology

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“…Therapeutic approaches to dystonia are equally broad. Bledsoe et al provide a masterful overview of the many existing and emerging therapies for dystonia, ranging from pathogenesis-targeted therapies to symptomatic treatments with drugs or botulinum toxin, surgical therapies, noninvasive stimulation, and rehabilitation [20]. They highlight the need for an individualized approach to each patient and provide a helpful starting point for clinicians.…”

Section: Therapeutics In Other Movement Disordersmentioning

confidence: 99%

Therapeutic Advances in Movement Disorders

Tanner

Ostrem

2020

Neurotherapeutics

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“…This chapter will address rating scales and goals for treatment and will include a review of symptomatic treatment and, where possible, the treatment of the underlying disease processes. Several common pediatric disorders will not be covered in this chapter, including tics and Tourette syndrome [1] and isolated dystonia [2], which are covered in other chapters of this special edition.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Disorders of Tone and Other Considerations in Pediatric Movement Disorders

Tilton

2020

Neurotherapeutics

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Pediatric movement disorders (PMDs) consist of a heterogeneous group of signs and symptoms caused by numerous neurological diseases. Different neurological disorders in children also share overlapping movement disorders making a diagnosis of the underlying cause of the movement disorder challenging. The similarity of the symptoms across multiple disease types suggests that there may be a final common motor pathway causing the overlapping movement disorders. There are numerous disorders in children associated with disturbances in tone and involuntary movements. This chapter will focus primarily on those disorders that involve abnormalities of tone and other important considerations of pediatric movement disorders. This chapter will address rating scales and goals for treatment and will include a review of symptomatic treatment and, where possible, the treatment of the underlying disease processes. The chapter will review representative disorders, including an inborn error of metabolism, an autoimmune disorder, and a group of neurodegenerative disorders. These examples demonstrate how the disorder's underlying pathophysiology results in a specific approach to the underlying disease and the associated conditions of tone and involuntary movements. Finally, the multiple treatment options for cerebral palsy and considerations of cerebral palsy mimics will be discussed.

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Treatment of Dystonia: Medications, Neurotoxins, Neuromodulation, and Rehabilitation

Cited by 25 publications

References 241 publications

The Dystonias

The Dystonias

Therapeutic Advances in Movement Disorders

Treatment of Disorders of Tone and Other Considerations in Pediatric Movement Disorders

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