Trip Answers

Question answered:15/03/07 Warning! this question is over two years old.

We searched the TRIP and Medline databases but found no guidelines or studies specifically addressing the issue of treating non-localised dystonia.

 

The National Institute of Neurological Disorders and Stroke has produced a fact sheet on dystonias in which they discuss therapies for dystonia:

 

“No one treatment has been found universally effective. Instead, physicians use a variety of therapies aimed at reducing or eliminating muscle spasms and pain.

 
Medication. Several classes of drugs that may help correct imbalances in neurotransmitters have been found useful. But response to drugs varies among patients and even in the same person over time. The most effective therapy is often individualized, with physicians prescribing several types of drugs at different doses to treat symptoms and produce the fewest side effects…”

 

This source proceeds to describe various groups of drugs used to treat dystonias but does not  distinguish between therapies for focal, multifocal or generalized dystonias. [1]

 

The Dystonia Medical Research Foundation restricts itself to offering general information on the treatment of these disorders:

 

“Although there is presently no cure for dystonia, multiple treatment options are available. Because every person with dystonia is unique, treatment must be highly customized to the need of the individual. No single strategy will be appropriate for every case.

 

“The first step in treating dystonia is to determine as much as possible about the underlying cause. Information about the cause of dystonia may direct the course of treatment. For example, a person with dystonia associated with another neurological disorder will require a slightly different approach that a person with a primary focal dystonia.

 

The treatment options for dystonia generally consists of several approaches:
• Non-drug therapies
• Oral medications
• Injected medications
• Surgery
• Complementary therapies.”

 

There are many medications that have been shown to improve dystonia. No single drug works for every individual, and several trials of medications may be necessary to determine which is most appropriate for you. There are several categories of medications used in the treatment of dystonia. These categories include:
• Anticholinergics
• Benzodiazepines
• Baclofen
• Dopaminergic agents/Dopamine-depleting agents
• Tetrabenezine.” [2]

 

Given the requirement to adopt a patient specific approach to treating non-local dystonias, the NLH Q & A Service can only suggest discussing this case with a neurologist.

References
1. National Institute of Neurological Disorders and Stroke (NINDS). Fact sheet on dystonias.December 2003. (http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm#82953257).
2. Dystonia Medical Research Foundation. Treatments. (http://www.dystonia-foundation.org/pages/treatments/6.php); (http://www.dystonia-foundation.org/pages/oral_medications/121.php); http://www.dystonia-foundation.org/pages/oral_medications/121.php

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