Bulletin de l'Academie Nationale de Medecine 2011-01-01

[Medical aspects of the medical treatment in dystonia].

David Grabli, Marie Vidailhet

Index: Bull. Acad. Natl. Med. 195(4-5) , 935-50, (2011)

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Abstract

Dystonias encompass a wide range of movement disorders characterized mainly by abnormal postures or movements. Because of this semiological and etiological heterogeneity, robust clinical trials are rare. Specific etiological treatments are available for only a few forms (e.g. Wilson's disease and dopa-responsive dystonia), which places the emphasis on symptomatic treatment. This is based on the combinations of three complementary approaches: drug therapy (anticholinergics, tetrabenazine and benzodiazepines are first-line drugs, but many others have been tested in small clinical trials), botulinium toxin injections in case of focal dystonia or focal targets in patients with more widespread dystonia, and physiotherapy. This review provides a short overview of available treatments and proposes a basic therapeutic strategy for dystonic patients.