Treatment of Dystonia

Therapeutic strategies in the treatment of dystonia consist primarily of pharmacologic, surgical, and supportive approaches. Many recent advances have been made in the treatment of dystonia with newer medications, availability of different botulinum toxins, and surgical procedures. However, these treatment modalities all have limiting factors and varying levels of efficacy. Studies range from case reports and open-label trials to double-blind placebo-controlled trials. More research and larger studies are needed to explore these newer medications and surgical techniques for both primary focal and generalized dystonia. Studies in functional outcome and quality of life further support the importance of discovering safe and effective means to treat dystonia. An algorithmic approach may be useful to guide the physician along the various treatment choices.

[1]  S Fahn,et al.  Development of resistance to botulinum toxin type A in patients with torticollis , 2004, Movement disorders : official journal of the Movement Disorder Society.

[2]  Christine Klein,et al.  Dystonia: clinical features, genetics, and treatment , 2002, Current opinion in neurology.

[3]  M. Hallett,et al.  Sensory training for patients with focal hand dystonia , 2002, Annals of neurology.

[4]  J. Volkmann,et al.  Deep brain stimulation for dystonia: Patient selection and evaluation , 2002, Movement disorders : official journal of the Movement Disorder Society.

[5]  Laurent Vercueil,et al.  Deep brain stimulation of the corpus luysi (subthalamic nucleus) and other targets in Parkinson's disease. Extension to new indications such as dystonia and epilepsy , 2001, Journal of Neurology.

[6]  M. Benninger,et al.  Outcomes of botulinum toxin treatment for patients with spasmodic dysphonia. , 2001, Archives of otolaryngology--head & neck surgery.

[7]  R. Hilker,et al.  Health related quality of life is improved by botulinum neurotoxin type A in long term treated patients with focal dystonia , 2001, Journal of neurology, neurosurgery, and psychiatry.

[8]  Laurent Vercueil,et al.  Deep brain stimulation in the treatment of severe dystonia , 2001, Journal of Neurology.

[9]  T. Aziz,et al.  Bilateral internal globus pallidus stimulation for the treatment of spasmodic torticollis , 2001, Movement disorders : official journal of the Movement Disorder Society.

[10]  D. Tarsy,et al.  Impact on quality of life of botulinum toxin treatments for spasmodic dysphonia and oromandibular dystonia. , 2001, Archives of otolaryngology--head & neck surgery.

[11]  J. Kulisevsky,et al.  Bilateral pallidal stimulation for cervical dystonia: dissociated pain and motor improvement. , 2000, Neurology.

[12]  U. Bonuccelli,et al.  Mexiletine in the Treatment of Torticollis and Generalized Dystonia , 2000, Clinical neuropharmacology.

[13]  S. Hemm,et al.  Treatment of DYT1-generalised dystonia by stimulation of the internal globus pallidus , 2000, The Lancet.

[14]  C. Sabatti,et al.  The DYT1 phenotype and guidelines for diagnostic testing , 2000, Neurology.

[15]  V. Tronnier,et al.  Pallidal stimulation for generalized dystonia. Report of three cases. , 2000, Journal of neurosurgery.

[16]  J. Perlmutter,et al.  Efficacy and safety of a new bulk toxin of botulinum toxin in cervical dystonia: a blinded evaluation. , 1999, Clinical neuropharmacology.

[17]  J. Burgunder,et al.  Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia , 1999, The Lancet.

[18]  S. Fahn,et al.  A geste antagoniste device to treat jaw‐closing dystonia , 1999, Movement disorders : official journal of the Movement Disorder Society.

[19]  M. Hallett,et al.  An open trial of clozapine for dystonia , 1999, Movement disorders : official journal of the Movement Disorder Society.

[20]  J. Jankovic,et al.  Comparison of mouse bioassay and immunoprecipitation assay for botulinum toxin antibodies , 1999, Journal of neurology, neurosurgery, and psychiatry.

[21]  Eckart Altenmüller,et al.  Constraint-induced movement therapy for focal hand dystonia in musicians , 1999, The Lancet.

[22]  R. Hayashi,et al.  Mexiletine in the treatment of blepharospasm: Experience with the first three patients , 1999, Movement disorders : official journal of the Movement Disorder Society.

[23]  K. Toyka,et al.  Depletion of neutralising antibodies resensitises a secondary non-responder to botulinum A neurotoxin , 1998, Journal of neurology, neurosurgery, and psychiatry.

[24]  R. Hayashi,et al.  Mexiletine in the treatment of spasmodic torticollis , 1998, Movement disorders : official journal of the Movement Disorder Society.

[25]  C. Gudex,et al.  Effect of dystonia and botulinum toxin treatment on health‐related quality of life , 1998, Movement disorders : official journal of the Movement Disorder Society.

[26]  J. Jankovic,et al.  Pallidotomy for generalized dystonia , 1998, Movement disorders : official journal of the Movement Disorder Society.

[27]  M. Hallett,et al.  The pathophysiology of primary dystonia. , 1998, Brain : a journal of neurology.

[28]  M. Hallett The neurophysiology of dystonia. , 1998, Archives of neurology.

[29]  J. Jankovic,et al.  Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections , 1998, Movement disorders : official journal of the Movement Disorder Society.

[30]  J. Jankovic,et al.  Symptomatic and functional outcome of surgical treatment of cervical dystonia , 1997, Journal of neurology, neurosurgery, and psychiatry.

[31]  J. Dostrovsky,et al.  Globus pallidus internus pallidotomy for generalized dystonia , 1997, Movement disorders : official journal of the Movement Disorder Society.

[32]  R. Bakay,et al.  The role of pallidotomy in Parkinson's disease and dystonia. , 1997, Current opinion in neurology.

[33]  M. Brin,et al.  Use of intrathecal baclofen in the treatment of patients with dystonia. , 1996, Archives of neurology.

[34]  P. Fasick,et al.  Continuous intrathecal baclofen infusion for symptomatic generalized dystonia. , 1996, Neurosurgery.

[35]  M. H. Prins,et al.  Botulinum toxin versus trihexyphenidyl in cervical dystonia , 1996, Neurology.

[36]  K. Schwartz,et al.  Response and immunoresistance to botulinum toxin injections , 1995, Neurology.

[37]  M. Aramideh,et al.  Botulinum toxin in cervical dystonia: low dosage with electromyographic guidance , 1995, Journal of Neurology.

[38]  S. Fahn,et al.  Spread of symptoms in idiopathic torsion dystonia , 1995, Movement disorders : official journal of the Movement Disorder Society.

[39]  M. Hallett,et al.  Training guidelines for the use of botulinum toxin for the treatment of neurologic disorders , 1994, Neurology.

[40]  P. Greene,et al.  Baclofen in the treatment of dystonia. , 1992, Clinical neuropharmacology.

[41]  C. Tanner,et al.  Botulinum toxin injection for spasmodic torticollis , 1992, Neurology.

[42]  W. Koller,et al.  Electromyographic guidance of botulinum toxin treatment in cervical dystonia. , 1991, Clinical neuropharmacology.

[43]  W. Litchy,et al.  Selective peripheral denervation for torticollis: preliminary results. , 1991, Mayo Clinic proceedings.

[44]  J. Jankovic,et al.  Botulinum toxin treatment of cranial-cervical dystonia, spasmodic dysphonia, other focal dystonias and hemifacial spasm. , 1990, Journal of neurology, neurosurgery, and psychiatry.

[45]  C. Marsden,et al.  Torsion dystonia , 1986, Neurology.

[46]  M. Harrison,et al.  Stereotaxic thalamotomy in 55 cases of dystonia. , 1983, Brain : a journal of neurology.

[47]  Joseph H. Friedman,et al.  Myoclonic dystonia , 2004, Child's Nervous System.

[48]  K. Bötzel,et al.  Chronic high‐frequency globus pallidus internus stimulation in different types of dystonia: A clinical, video, and MRI report of six patients presenting with segmental, cervical, and generalized dystonia , 2002, Movement disorders : official journal of the Movement Disorder Society.

[49]  D. Figgitt,et al.  Botulinum toxin B: a review of its therapeutic potential in the management of cervical dystonia. , 2002, Drugs.

[50]  W. Poewe,et al.  Riluzole therapy in cervical dystonia , 2002, Movement disorders : official journal of the Movement Disorder Society.

[51]  A. Desautels,et al.  Effects of immobility on sensory and motor symptoms of restless legs syndrome , 2002, Movement disorders : official journal of the Movement Disorder Society.

[52]  M. Brin,et al.  Cervical dystonia pathophysiology and treatment options. , 2001, Drugs.

[53]  J. Jankovic,et al.  Focal dystonia: The role of botulinum toxin , 2001, Current neurology and neuroscience reports.

[54]  B. Jabbari,et al.  Treatment of movement disorders with trihexyphenidyl , 1989, Movement disorders : official journal of the Movement Disorder Society.

[55]  S. Fahn,et al.  Analysis of open‐label trials in torsion dystonia using high dosages of anticholinergics and other drugs , 1988, Movement disorders : official journal of the Movement Disorder Society.

[56]  I. S. Cooper 20-year followup study of the neurosurgical treatment of dystonia musculorum deformans. , 1976, Advances in neurology.

[57]  Cooper Is 20-year followup study of the neurosurgical treatment of dystonia musculorum deformans. , 1976 .