Treatment of dystonia.
Dystonia, defined as a neurological syndrome characterised by involuntary, patterned, sustained, or repetitive muscle contractions of opposing muscles, causing twisting movements and abnormal postures, is one of the most disabling movement disorders. Although gene mutations and other causes are increasingly recognised, most patients have primary dystonia without a specific cause. Although pathogenesis-targeted treatment is still elusive, the currently available symptomatic treatment strategies are quite effective for some types of dystonia in relieving involuntary movements, correcting abnormal posture, preventing contractures, reducing pain, and improving function and quality of life. A small portion of patients have a known cause and respond to specific treatments, such as levodopa in dopa-responsive dystonia or drugs that prevent copper accumulation in Wilson's disease. Therapeutic options must be tailored to the needs of individual patients and include chemodenervation with botulinum toxin injections for patients with focal or segmental dystonia, and medical treatments or deep brain stimulation for patients with generalised dystonia.
Jankovic
Joseph
J
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA. josephj@bcm.tmc.edu
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000627:therapeutic use; D004421:Dystonia / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017408:Guidelines as Topic; D006801:Humans; D026741:Physical Therapy Modalities
D018726:Anti-Dyskinesia Agents; D018680:Cholinergic Antagonists; D015259:Dopamine Agents; D018492:Dopamine Antagonists; D001905:Botulinum Toxins