Diagnosis and Treatment of Dystonia

Abstract

Synopsis The dystonias are a group of disorders characterized by excessive involuntary muscle contractions leading to abnormal postures and/or repetitive movements. There are many different clinical manifestations and many different causes. A careful assessment of the clinical manifestations is helpful for identifying syndromic patterns that focus diagnostic testing on potential causes. If a cause can be identified, specific etiology-based treatments may be available. However, in the majority of cases, a specific cause cannot be identified, and treatments are based on symptoms. Treatment options include counseling and education, oral medications, botulinum toxin injections, and several surgical procedures. A substantial reduction in symptoms and improved quality of life can be achieved in the majority of patients by combining these various options.

Electromyography Diagnosis and Treatment with Botulin Toxin for Hemi facial Post Paralytic Spasm, Case Report

“…The ophthalmologic and neurologic exams are essential to stablish a diagnosis of essential benign spasm or secondary to systemic diseases like in Parkinson disease 5 .…”

“…4 The contraindications for application of Botulin toxin are rare because is a drug classified as C category and their use is contraindicated during pregnancy, breastfeeding and neuromuscular diseases as myasthenia gravis, Eaton-Lambert syndrome and lateral amyotrophic sclerosis. This drug must be administered carefully in patients with consume of aminoglycosides, tetracycline, polymyxins, penicillin, anticholinesterases, and calcium channel blockers, because this may alter the conduction in the neuromuscular union 4, 5,9 .…”

Collum-caput (COL-CAP) concept for conceptual anterocollis, anterocaput, and forward sagittal shift

“…Dystonia is defined as involuntary, centrally-driven muscle hypercontraction, which may be sustained (spasmodic), resulting in abnormal posture, or may be repetitive, resulting in rhythmic dystonic tremor or phasic cloniform dystonia, or both [1,2]. Dystonia may be painless or painful and may slow voluntary movements and reduce range of motion [1,2].…”

“…Dystonia may be painless or painful and may slow voluntary movements and reduce range of motion [1,2]. Concerning the distribution, dystonia may be focal, multifocal, segmental, or generalised.…”

Dystonia treatment

“…Multiple publications summarize and list treatment options for dystonia. [4][5][6] Generally, the most common oral medication classes identified in these reviews are anticholinergics, dopaminergics, GABAergics, and muscle relaxants, as included in our study. We acknowledge the limitations and lack of evidence-based prescribing strategies due to an absence of large, controlled studies, highlighted in systematic evidence-based reviews.…”