Spasmodic torticollis: medical and botulinum A toxin treatment.
The exact pathophysiologic mechanisms of spasmodic torticollis and other idiopathic torsion dystonias remain largely unknown. Thus, a variety of drugs have been used alone or in combination on an empirical basis to treat these disorders, but to date none have efficacy that is proven and consistent. The drugs in use include anticholinergics, benzodiazepines, dopaminergics and dopamine antagonists with variable degrees of clinical improvement. Botulinum toxin A injection treatment for spasmodic torticollis is safe and efficacious with minimal adverse effect. However, it is expensive and beneficial effects are short-lasting. Only when a spasmodic torticollis patient's symptoms are refractory to combined treatment, using various drugs and Botulinum toxin injections, should the patient be considered a candidate for neurosurgical procedures.
Lee
M C
MC
Department of Neurology, Asan Medical Center Ulsan University College of Medicine, Seoul, Korea.
D001569:Benzodiazepines / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use*; D015259:Dopamine Agents / Q000627:therapeutic use; D018492:Dopamine Antagonists; D006801:Humans; D010276:Parasympatholytics / Q000627:therapeutic use; D013035:Spasm / Q000188:drug therapy*; D014103:Torticollis / Q000188:drug therapy*
D015259:Dopamine Agents; D018492:Dopamine Antagonists; D010276:Parasympatholytics; D001569:Benzodiazepines; D001905:Botulinum Toxins