title: Treatment strategies in movement disorders.
abstract: Strategies in treatment of movement disorders are discussed with the illustration of three patients with dystonia. Pharmacotherapy can be applied in two ways: (1) a precise directed therapy, or (2) a 'shotgun' approach. Botulinum toxin is successfully injected in focal and segmental forms of movement disorders. Stereotactic neurosurgery can be considered in pharmacotherapy-resistant dystonias, but also in other forms of movement disorders. Intrathecal baclophen treatment by continuous infusion is only indicated in severe forms of spasticity.
authors.affiliation: Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. j.d.speelman@amc.uva.nl
authors.forename: J D
authors.initials: JD
authors.lastname: Speelman
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000188:drug therapy / Q000628:therapy; D004295:Dihydroxyphenylalanine / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D004421:Dystonia / Q000188:drug therapy; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000188:drug therapy / Q000628:therapy*; D019635:Neurosurgical Procedures; D026741:Physical Therapy Modalities
chemical_list: D015259:Dopamine Agents; D004295:Dihydroxyphenylalanine; D001905:Botulinum Toxins