Dystonia.
BACKGROUND
Dystonia is usually a lifelong condition with persistent pain and disability. Focal dystonia affects a single part of the body; generalised dystonia can affect most or all of the body. It is more common in women, and some types of dystonia are more common in people of European Ashkenazi Jewish descent.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments, surgical treatments, and physical treatments for focal, and for generalised dystonia? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 13 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: acetylcholine receptor inhibitors, acupuncture, anticholinergic drugs, anticonvulsants, atypical antipsychotic drugs, benzodiazepines, biofeedback, botulinum toxin, chiropractic manipulation, deep brain stimulation of thalamus and globus pallidus, dopaminergic agonists and antagonists, gamma-aminobutyric acid (GABA) inhibitors, microvascular decompression, myectomy, occupational therapy, osteopathy, pallidotomy, physiotherapy, selective peripheral denervation, serotonergic agonists and antagonists, speech therapy, and thalamotomy.
Snaith
Ailsa
A
University of Aberdeen, Aberdeen, UK.
Wade
Derick
D
D001905:Botulinum Toxins / Q000008:administration & dosage; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000188:drug therapy; D004422:Dystonia Musculorum Deformans / Q000188:drug therapy; D020821:Dystonic Disorders / Q000188:drug therapy; D005500:Follow-Up Studies; D018756:GABA Antagonists / Q000627:therapeutic use; D005917:Globus Pallidus; D006801:Humans
D018756:GABA Antagonists; D001905:Botulinum Toxins