Although there is currently no cure for dystonia, there are several widely used treatments. Many treatments are very successful but depend particularly on the type of dystonia and the age of onset. Because dystonia is such a complex and ‘individual’ condition, the usefulness of all these treatment options can vary widely between patients. Treatment regimes should be determined by a consultant familiar with dystonia.
The usual treatment regime for common forms of adult onset dystonia such as cervical dystonia, facial dystonia, oromandibular dystonia and blepharospasm is regular injections of botulinum toxin, which are usually repeated every three months.
Various oral medications drug treatments are available to assist in the management of some types of dystonia. However, not all medications are suitable for all people with dystonia.
In rare cases where cervical dystonia does not respond to botulinum toxin, Deep Brain Stimulation (DBS) brain surgery may be considered. Other surgical treatments which aim to either remove the problematic muscles or cut (denervate) selective peripheral nerves leading to these muscles, have also been found to be helpful for people with blepharospasm and torticollis respectfully.
Many physicians will prescribe an initial trial of Levodopa for young patients as it can be highly effective in cases of dopa-responsive dystonia
Unfortunately, in the majority of cases, other oral drugs will be required of which Trihexyphenidyl is the most widely used. However, there are a number of other drug treatments available.
DBS brain surgery, especially in cases of generalised dystonia, can be of sustained benefit to certain young patients. Assessment will be required to determine whether DBS is suitable for individual cases. Botulinum toxin has limited use in the case of generalised dystonia as there are too many diverse muscles groups to treat successfully. It is used most successfully in the treatment of specific muscle groups.
Treatment of dystonia secondary to brain injury is often similar to that of young-onset dystonia. DBS is reported to be less successful in managing cases of secondary dystonia, as is botulinum toxin, although it can be useful when targeting specific small areas of muscle.
For people with tardive dystonia (dystonia, which is a side effect to certain medications), the use of further medications to treat the symptoms of dystonia, needs to be managed very carefully.
Last reviewed October 2011
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