Efficacy of pharmacological treatment of dystonia: evidence‐based review including meta‐analysis of the effect of botulinum toxin and other cure options

Balash, Yacov; Giladi, Nir

doi:10.1111/j.1468-1331.2004.00845.x

Cited by 121 publications

(67 citation statements)

References 92 publications

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“…Affected patients suffer from repetitive twisting movements or abnormal postures due to involuntary muscle contractions [1,2] . While conservative (medical) treatment options are extremely limited for generalized dystonia, in segmental dystonia, injections of botulinum toxin can alleviate symptoms for extended periods, but can also fail after repeated application [3,4] .…”

Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia

Mehrkens¹,

Bötzel

Steude³

et al. 2008

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) offers a very promising therapy for medically intractable dystonia. However, little is known about the long-term benefit and safety of this procedure. We therefore performed a retrospective long-term analysis of 18 patients (age 12–78 years) suffering from primary generalized (9), segmental (6) or focal (3) dystonia (minimum follow-up: 36 months). Methods: Outcome was assessed using the Burke-Fahn-Marsden (BFM) scores (generalized dystonia) and the Tsui score (focal/segmental dystonia). Follow-up ranged between 37 and 90 months (mean 60 months). Results: Patients with generalized dystonia showed a mean improvement in the BFM movement score of 39.4% (range 0–68.8%), 42.5% (range –16.0 to 81.3%) and 46.8% (range –2.7 to 83.1%) at the 3- and 12-month, and long-term follow-up, respectively. In focal/segmental dystonia, the mean reduction in the Tsui score was 36.8% (range 0–100%), 65.1% (range 16.7–100%) and 59.8% (range 16.7–100%) at the 3- and 12-month, and long-term follow-up, respectively. Local infections were noted in 2 patients and hardware problems (electrode dislocation and breakage of the extension cable) in 1 patient. Conclusion: Our data showed Gpi-DBS to offer a very effective and safe therapy for different kinds of primary dystonia, with a significant long-term benefit in the majority of cases.

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Section: Introductionmentioning

confidence: 99%

Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia

Mehrkens¹,

Bötzel

Steude³

et al. 2008

Stereotact Funct Neurosurg

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“…It acts by inducing chemodenervation of the affected muscles. Currently, several botulinum toxin formulations are available and widely used in the treatment of dystonias, and are the first line treatment for focal and segmental dystonias 97 . A recent evidence-based review of botulinum toxin in movement disorders supports the use of botulinum toxin in several types of dystonias.…”

Section: As Shown Inmentioning

confidence: 99%

Understanding dystonia: diagnostic issues and how to overcome them

Camargos

Cardoso

2016

Arq. Neuro-Psiquiatr.

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The diagnosis and treatment of dystonia are challenging. This is likely due to gaps in the complete understanding of its pathophysiology, lack of animal models for translational studies, absence of a consistent pathological substrate and highly variable phenotypes and genotypes. The aim of this review article is to provide an overview of the clinical, neurophysiological and genetic features of dystonia that can help in the identification of this movement disorder, as well as in the differential diagnosis of the main forms of genetic dystonia. The variation of penetrance, age of onset, and topographic distribution of the disease in carriers of the same genetic mutation indicates that other factors -either genetic or environmental -might be involved in the development of symptoms. The growing knowledge of cell dysfunction in mutants may give insights into more effective therapeutic targets.Keywords: dystonia; apoptosis. RESUMOO diagnóstico e o tratamento da distonia podem ser desafiadores. Isso se dá provavelmente a pouca compreensão da fisiopatologia, a falta de modelos animais para estudos translacionais, ausência de um substrato patológico consistente e genótipo e fenótipo altamente variáveis. O objetivo deste artigo de revisão é fornecer uma visão geral dos aspectos clínicos, neurofisiológicos e genéticos de distonia que podem ajudar na identificação deste distúrbio do movimento, bem como no diagnóstico diferencial das principais formas de distonia hereditária. Há uma ênfase particular na nova definição e classificação da Internacional das Distonias, bem como as recentes descobertas dos mecanismos moleculares subjacentes em algumas formas de distonia primária. A variação de penetrância, idade de início, e distribuição topográfica da doença em portadores da mesma mutação genética indica que outros fatores -genéticos ou ambientais podem estar envolvidos no desenvolvimento dos sintomas. O conhecimento crescente sobre a disfunção celular em mutantes pode gerar insights sobre alvos terapêuticos mais eficazes.Palavras-chave: distonia; apoptose

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“…Oral medication is the usual first line of treatment. There is no evidence-based information about the efficacy of the different pharmacologic therapeutic options currently being applied in dystonia (13). Medications are prescribed in early stages and may have some effects in controlling dystonic movements.…”

Section: Treatmentmentioning

confidence: 99%

Oromandibular dystonia: A dental approach

Maestre-Ferrín¹,

Burguera²,

Peñarrocha-Diago³

et al. 2009

Med Oral

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Oromandibular dystonia consists of prolonged spasms of contraction of the muscles of the mouth and jaw. Primary idiopathic forms and secondary forms exist. Secondary dystonia develops due to environmental factors; some cases of cranial dystonia after dental procedure have been reported, but the causal relationship between these procedures and dystonia remains unclear. Traumatic situations in the mouth, such as poor aligned dentures or multiple teeth extractions may cause an impairment of proprioception of the oral cavity, leading to subsequent development of dystonia. The clinical characteristics of oromandibular dystonia are classified according to the affected muscles. The muscles involved may be the muscles of mastication, muscles of facial expression, or the muscles of the tongue. At present, there is no known cure for OMD. The mainstay of treatment for most focal dystonia is botulinum toxin injections. It is important for the dentist to be familiar with oromandibular dystonia, as it can develop after dental treatment and is often misdiagnosed as a dental problem.

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Efficacy of pharmacological treatment of dystonia: evidence‐based review including meta‐analysis of the effect of botulinum toxin and other cure options

Cited by 121 publications

References 92 publications

Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia

Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia

Understanding dystonia: diagnostic issues and how to overcome them

Oromandibular dystonia: A dental approach

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