Treatment Of Dystonia

Comprehensive reference for neurologists, neurosurgeons and physical therapists on the treatment of all dystonias in children and adults.

Our understanding of dystonia is advancing rapidly. This comprehensive reference work provides an effective guide to this challenging group of disorders, offering an overview of the current and emerging treatment options for all manifestations. Treatments for the many forms of dystonia differ substantially in pediatrics and adults - both are covered in detail in this book. Approaches include botulinum toxin therapy, deep brain stimulation, oral drug applications, rehabilitation, and behavioral and experimental therapies. Special emphasis is also given to combining different treatment modalities in order to achieve optimal effect. Treatment of Dystonia brings together peer-reviewed articles, written by experts and based on work presented at international conferences. By enabling the physician to select and combine the best therapies, it is an essential resource for neurologists, neurosurgeons and physical therapists.

Movement Disorder Emergencies: Diagnosis and Treatment provides a fresh and unique approach to what is already a high-profile subspecialty area in clinical neurology. The disorders covered in this volume are standard fare in the field but emphasize the urgencies and emergencies that can occur. One of the very attractive features of the field of movement disorders is that diagnosis is often based on unique visible and sometimes audible phenomenological symptoms and signs. Therefore, in this era of highly sophisticated laboratory and radiological diagnostic tools, the diagnosis of many movement disorders is still largely made in the clinic where pattern recognition is key. Crucial to astute clinical diagnosis is broad clinical experience. In short, you have to have seen one to recognize one! Patients with movement disorders nearly always present as outpatients but, as aptly recognized by Drs. Frucht and Fahn, this may include acute manifestations leading to emergency presentations, often in an emergency room setting, where they are very likely to be unrecognized and therefore poorly managed. The authors define an “emergency” movement disorder as one in which failure to promptly diagnose and treat may result in significant morbidity or mortality. However, they also stress the importance of certain “can’t miss” diagnoses such as Wilson’s disease, dopa-responsive dystonia, and Whipple’s disease in which delayed diagnosis in less emergent situations can lead to slowly evolving and often irreversible neurological damage with tragic consequences.

This volume is the third in a series developed under the auspices of the World Federation of Neurology to meet the needs of neurologists who must practice medicine without many of the advantages that are often taken for granted in the industrialized world. It is targeted to neurologists practicing in low-resource environments and those who wish to practice cost-effective neurology, and addresses issues important for neurologists in developing countries that are not covered in standard textbooks. The series will update the reader in currently accepted diagnostic and management practice. Material is presented in a user-friendly, interactive manner, with abundant case material. Dystonia is the third most common movement disorder after Parkinson's disease and Tremor. It is a neurologic disorder characterized by involuntary, sustained, patterned and often repetitive muscle contractions of opposing muscles that force parts of the body into abnormal and sometimes painful postures. Dystonia can affect any part of the body and while not fatal, it is a chronic and debilitating disorder. Managing dystonic conditions can be difficult in developing countries where there are limited diagnostic and therapeutic resources. The use of botulinum toxin, considered the treatment of choice for many focal or segmental dystonias, is discussed in regard to its cost effectiveness in the setting of limited resources. Dystonia provides a practical review of the disorder that emphasizes cost-effective evaluation and treatment and advice on how to apply the current knowledge in clinical practice. This text will be a welcome edition to the international literature on the subject.

As many as 250,000 people in the United States have dystonia, making it the third most common movement disorder following essential tremor and Parkinson's disease. Authoritative and reader-friendly, Handbook of Dystonia, Second Edition provides a wide-ranging overview of the latest research and developments regarding the pathogenesis, evaluation, and management of the disease. The book offers detailed coverage of every available treatment option for dystonia and includes four categorized sections on medical management, botulinum toxin injections, phenol and neurolytic therapy, and surgical intervention. The book reviews the genetic factors of dystonia and supplies in-depth coverage of the neuroanatomy, neurophysiology, and neuropathology of the disease. It covers secondary causes of dystonia, including drug-induced and psychogenic presentations. It also examines non-motor symptoms relating to movement disorders and analyzes innovative approaches for treatment including deep brain stimulation. New to the Second Edition: Four new chapters dedicated to the discussion of individual botulinum toxins recently approved to treat dystonia: Botox, Myobloc, Disport, and Xeomin Dystonic symptoms associated with Parkinson’s disorders The use of Transcranial Magnetic Stimulation (TMS) as a treatment option for dystonia Spasticity and its pathogenesis, evaluation, and treatment with toxins, other injectables and surgical therapies Summarizing what is known about the disorder, the book dramatically improves the recognition and understanding of this debilitating disease.

DIAGNOSTIC STUDIES -- TREATMENT -- POTENTIAL DISEASE COMPLICATIONS -- POTENTIAL TREATMENT COMPLICATIONS -- Chapter 11. Biceps Tendinitis -- DEFINITION -- SYMPTOMS -- PHYSICAL EXAMINATION -- FUNCTIONAL LIMITATIONS -- DIAGNOSTIC STUDIES -- TREATMENT -- POTENTIAL DISEASE COMPLICATIONS -- POTENTIAL TREATMENT COMPLICATIONS -- Chapter 12. Biceps Tendon Rupture -- DEFINITION -- SYMPTOMS -- PHYSICAL EXAMINATION -- FUNCTIONAL LIMITATIONS -- DIAGNOSTIC STUDIES -- TREATMENT -- POTENTIAL DISEASE COMPLICATIONS -- POTENTIAL TREATMENT COMPLICATIONS -- Chapter 13. Glenohumeral Instability -- DEFINITIONS

This case-based text provides treatment approaches to common and uncommon movement disorders. The first two parts of the book are devoted to the wide spectrum of motor and non-motor problems encountered in caring for people with Parkinson’s disease, as well as Parkinsonian syndromes. Next are parts with chapters addressing essential and other tremor disorders followed by management of the various dystonic syndromes and other hyperkinetic disorders including chorea, tics, and myoclonus. Other disorders covered are drug-induced movement disorders, psychogenic movement disorders, Wilson’s disease, hemifacial spasm and more. Authored by experts globally, this practical guide will help physicians, other healthcare professionals and trainees care for patients with a wide spectrum of movement disorder related problems.

The current concept of dystonic movement connects the abnormal function of somatosensory pathways and somatosensory analyzers with the dystonic performance of motor action, which is based on the abnormality of sensorimotor integration. This concept is reflected not only in idiopathic dystonia, but also in secondary and symptomatic dystonias. This book will give a comprehensive account of the history of the terms dystonia and dystonic, the physiology of dystonic movement and the genetics and clinical appearance of primary and secondary dystonias. Taking into consideration latest research findings, Dystonia and Dystonic Syndromes offers an in-depth discussion of current treatment options available for dystonia, including pharmacotherapy, surgery and neurorehabilitation. Therefore, it serves as a valuable reference for practitioners in the fields of neurology, neurosurgery, psychiatry and neuroradiology as well as for neuroscientists.