Update on Treatments for Dystonia
Oral medication, botulinum toxin injections, and deep brain stimulation are the current mainstays of treatment for dystonia. In addition, physical and other supportive therapies may help prevent further complications (eg, contractures) and improve function. This review discusses evidence-based medical treatment of dystonia with an emphasis on recent advances in treatment. We will also review the current treatment approaches and suggest ways in which these therapies can be applied to individuals with dystonia.
KeywordsDystonia Treatment Medication Deep brain stimulation
Compliance with Ethics Guidelines
Conflict of Interest
D. Cristopher Bragg declares that he has no conflict of interest. Nutan Sharma has received consultancy fees from Merz Pharmaceuticals and Allergan; a grant from NIH (NIH/NINDS P50NS037409); honorarium payment from The American Academy of Neurology; and payment for development of an educational presentation from Oakstone Publishing.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 3.Swoboda KJ, Furukawa Y. Tyrosine Hydroxylase Deficiency. 2008 Feb 8. In: Pagon RA, Adam MP, Bird TD, et al., editors. GeneReviews [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2014. Available from: http://www.ncbi.nlm.nih.gov.ezp-prod1.hul.harvard.edu/books/NBK1437/. Accessed 8 Mar 2014.
- 5.Mathur SN, Chu SK, McCormick Z, Chien GCC, Marciniak CM. Long-term intrathecal baclofen: outcomes after more than 10 years of treatment. PM&R 2013; doi: 10.1016/j.pmrj.2013.12.005.
- 7.•Miyazaki Y, Sako W, Asanuma K, Izumi Y, Miki T, Kaji R. Efficacy of zolpidem for dystonia: a study among different subtypes. FNEURO. 2012;3:1–5. First evidence that zolpidem may be of benefit in dystonia.Google Scholar
- 12.Simpson DM, Blitzer A, Brashear A, et al. Assessment: botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70:1699–706.PubMedCrossRefGoogle Scholar
- 14.••Hallett M, Albanese A, Dressler D, Segal KR, Simpson DM, Truong D, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of movement disorders. Toxicon. 2013;67:94–114. Provides most comprehensive review regarding the use of botulinum toxin in focal dystonias.PubMedCrossRefGoogle Scholar
- 26.Borggraefe I, Mehrkens JH, Telegravciska M, Berweck S, Botzel K, Heinen F. Bilateral pallidal stimulation in children and adolescents with primary generalized dystonia report of six patients and literature-based analysis of predictive outcomes variables. Brain Dev. 2010;32:223–8.PubMedCrossRefGoogle Scholar