Any therapy for dystonia ?

Treatment team

Treatment for dystonia involves the interaction between a neurologist, psychiatrists, and physical and occupational therapists. Treatment may involve a neurosurgeon for symptoms that do not respond to medical management. Dystonia of childhood onset is treated by a pediatric neurologist cooperating with pediatricians and pediatric therapists.

Treatment

Treatment for dystonia is usually directed towards management of the symptoms and depends on the type of dystonia. Dystonia that is associated or caused by known etiologies such as drugs, Wilson's disease, or dopa-responsive dystonia may be improved by treating the underlying disease with resolution of symptoms. The various treatments available may be grouped into oral medications, botulinum toxin injections, and surgical modalities.

Medications

Various oral medications are available for the symptomatic treatment of dystonia. Among these are various medications that affect different neurochemical systems thought to be important in causing dystonia. Some patients with symptoms of early onset may have dystonia that responds dramatically to levodopa. Anticholinergics, dopamine depleting agents, benzodiazepines, baclofen, or atypical antipsychotics may be tried as well.

Botox

Chemical denervation using botulinum toxin has been used for many movement disorders including dystonia. Botulinum toxin blocks the transmission of nerve impulses to the muscle and paralyzes the overactive muscles involved. Focal forms of dystonia are more amenable to treatment due to the ease of localizing injectable muscles and less extensive involvement. Botox may be used in generalized dystonia to facilitate improvement in select muscles needed for daily function such as the arms and legs.

Surgical treatment

Selective destruction or high frequency stimulation of nerve centers involved in causing dystonia has been useful in treating selected patients with disabling symptoms. Patients with generalized dystonia or hemidystonia may benefit due to the widespread nature of symptoms, limiting the efficacy of medications and botox injections. Surgical lesioning of nerve cells in the globus pallidus or stimulation of cells in the globus pallidus or subthalamic nucleus have been shown to be effective in treating the symptoms of dystonia. The long-term benefit of surgical therapies on symptoms of dystonia has yet to be validated.

Physical therapy can sometimes help with focal dystonia. A structured set of exercises are tailored to help the affected area.