Latest & greatest articles for Dystonia

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Top results for Dystonia

1. Dystonias

Dystonias Dystonias - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Dystonias Last reviewed: February 2019 Last updated: January 2019 Summary Movement disorder characterised by sustained involuntary muscle contractions and abnormal postures of the trunk, neck, face, or extremities. The involuntary movements are associated with simultaneous contraction of agonist and antagonist muscles, with unwanted 'overflow (...) ' contraction of adjacent muscles. In some cases, pain in the affected muscles can be a prominent feature. Dystonia may improve with simple 'sensory tricks' such as lightly touching the affected body part (geste antagoniste). Can be generalised or focal, primary (with no other neurological abnormalities), or secondary to a structural lesion. Dopa-responsive dystonias, although rare, should always be considered if generalised, as levodopa is dramatically effective in these situations. Treatment

2019 BMJ Best Practice

2. Deep brain stimulation for dystonia. (PubMed)

Deep brain stimulation for dystonia. Dystonia is a painful and disabling disorder, characterised by painful, involuntary posturing of the affected body region(s). Deep brain stimulation is an intervention typically reserved for severe and drug-refractory cases, although uncertainty exists regarding its efficacy, safety, and tolerability.To compare the efficacy, safety, and tolerability of deep brain stimulation (DBS) versus placebo, sham intervention, or best medical care, including botulinum (...) outcome was symptom improvement on any validated symptomatic rating scale, and the primary safety outcome was adverse events.We included two RCTs, enrolling a total of 102 participants. Both trials evaluated the effect of DBS on the internal globus pallidus nucleus, and assessed outcomes after three and six months of stimulation. One of the studies included participants with generalised and segmental dystonia; the other included participants with focal (cervical) dystonia. We assessed both studies

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2019 Cochrane

3. A systematic review of the barriers and facilitators to the use of Botulinum toxin in cervical dystonia

A systematic review of the barriers and facilitators to the use of Botulinum toxin in cervical dystonia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

4. A systematic review of barriers and facilitators to participation in physical activity in people with cervical dystonia

A systematic review of barriers and facilitators to participation in physical activity in people with cervical dystonia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

5. Trihexyphenidyl for dystonia in cerebral palsy. (PubMed)

Trihexyphenidyl for dystonia in cerebral palsy. Cerebral palsy occurs in up to 2.1 of every 1000 live births and encompasses a range of motor problems and movement disorders. One commonly occurring movement disorder amongst those with cerebral palsy is dystonia: sustained or intermittent involuntary muscle spasms and contractions that cause twisting, repetitive movements and abnormal postures. The involuntary contractions are often very painful and distressing and cause significant limitations (...) to activity and participation.Oral medications are often the first line of medical treatment for dystonia. Trihexyphenidyl is one such medication that clinicians often use to treat dystonia in people with cerebral palsy.To assess the effects of trihexyphenidyl in people with dystonic cerebral palsy, according to the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) domains of impairment, activity and participation. We also assessed the type

2018 Cochrane

6. Injectable DaxibotulinumtoxinA in Cervical Dystonia: A Phase 2 Dose‐Escalation Multicenter Study (PubMed)

Injectable DaxibotulinumtoxinA in Cervical Dystonia: A Phase 2 Dose‐Escalation Multicenter Study Injectable daxibotulinumtoxinA (an investigational botulinum toxin, RT002) may offer a more prolonged duration of response-and therefore less frequent dosing-than onabotulinumtoxinA.To perform a phase 2, open-label, dose-escalation study to assess the efficacy and safety of daxibotulinumtoxinA in cervical dystonia.Subjects with moderate-to-severe isolated cervical dystonia were enrolled (...) site erythema (8%).Preliminary assessments suggest that injectable daxibotulinumtoxinA at doses up to 450 U is well tolerated and may offer prolonged efficacy in the treatment of cervical dystonia. Further studies involving larger numbers of patients are now warranted.

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2018 Movement disorders clinical practice

7. Systematic Review of Rehabilitation in Focal Dystonias: Classification and Recommendations (PubMed)

Systematic Review of Rehabilitation in Focal Dystonias: Classification and Recommendations Rehabilitation interventions are rarely utilized as an alternative or adjunct therapy for focal dystonias. Reasons for limited utilization are unknown, but lack of conclusive evidence of effectiveness is likely a crucial factor.The purpose of this systematic review was to determine the level of evidence for rehabilitation interventions in focal dystonias. Rehabilitation interventions were classified based (...) upon the underlying theoretical basis of different approaches, and the strength of evidence for each category was evaluated to identify gaps in the field. Prospective studies using rehabilitation methods in cervical, hand, and foot dystonia were reviewed. The key elements of treatments tested were identified and studies were grouped into six categories based on the theoretical basis of the intervention: (1) movement practice, (2) training with constraint, (3) sensory reorganization, (4

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2018 Movement disorders clinical practice

8. Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor

Randomised controlled trial of escitalopram for cervical dystonia with dystonic jerks/tremor Trials for additional or alternative treatments for cervical dystonia (CD) are scarce since the introduction of botulinum neurotoxin (BoNT). We performed the first trial to investigate whether dystonic jerks/tremor in patients with CD respond to the selective serotonin reuptake inhibitor (SSRI) escitalopram.In a randomised, double-blind, crossover trial, patients with CD received escitalopram (...) and placebo for 6 weeks. Treatment with BoNT was continued, and scores on rating scales regarding dystonia, psychiatric symptoms and quality of life (QoL) were compared. Primary endpoint was the proportion of patients that improved at least one point on the Clinical Global Impression Scale for jerks/tremor scored by independent physicians with experience in movement disorders.Fifty-threepatients were included. In the escitalopram period, 14/49 patients (29%) improved on severity of jerks/tremor versus 11

2018 EvidenceUpdates

9. Dystonias

Dystonias Dystonias - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Dystonias Last reviewed: February 2019 Last updated: January 2019 Summary Movement disorder characterised by sustained involuntary muscle contractions and abnormal postures of the trunk, neck, face, or extremities. The involuntary movements are associated with simultaneous contraction of agonist and antagonist muscles, with unwanted 'overflow (...) ' contraction of adjacent muscles. In some cases, pain in the affected muscles can be a prominent feature. Dystonia may improve with simple 'sensory tricks' such as lightly touching the affected body part (geste antagoniste). Can be generalised or focal, primary (with no other neurological abnormalities), or secondary to a structural lesion. Dopa-responsive dystonias, although rare, should always be considered if generalised, as levodopa is dramatically effective in these situations. Treatment

2018 BMJ Best Practice

10. Assessment of infantile dystonia

Assessment of infantile dystonia Assessment of infantile dystonia - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of infantile dystonia Last reviewed: February 2019 Last updated: June 2018 Summary Abnormal movement disorders are classified as parkinsonism, dystonia, tremor, chorea, myoclonus, tics, stereotypies, and complex movement disorder. Dystonia is described as contraction of both agonist (...) and antagonist muscles simultaneously, causing twisting and repetitive movements or abnormal postures. Fahn S, Bressman SB, Marsden CD. Classification of dystonia. Adv Neurol. 1998;78:1-10. http://www.ncbi.nlm.nih.gov/pubmed/9750897?tool=bestpractice.com The earlier the age of onset, the more generalised and severe the condition tends to be. Dystonic movements Dystonic movements are patterned and sustained. They repeatedly involve the same muscle groups. The urge to perform the dystonic movements is absent

2018 BMJ Best Practice

11. Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or Cervical Dystonia: A Review of Clinical Effectiveness

Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or Cervical Dystonia: A Review of Clinical Effectiveness Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or Cervical Dystonia: A Review of Clinical Effectiveness | CADTH.ca Find the information you need Switching Botulinum Toxin A Products for Patients with Upper Limb Spasticity or Cervical Dystonia: A Review of Clinical Effectiveness Switching Botulinum Toxin A Products for Patients (...) with Upper Limb Spasticity or Cervical Dystonia: A Review of Clinical Effectiveness Last updated: February 9, 2018 Project Number: RC0960-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of switching botulinum toxin A products for patients with upper limb spasticity? What is the clinical effectiveness of switching botulinum toxin A products for patients with cervical dystonia? Key Message No literature

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

12. Botulinum toxin type A therapy for cervical dystonia. (PubMed)

Botulinum toxin type A therapy for cervical dystonia. This is an update of a Cochrane Review first published in 2005. Cervical dystonia is the most common form of focal dystonia and is a highly disabling movement disorder characterised by involuntary, usually painful, head posturing. Currently, botulinum toxin type A (BtA) is considered the first line therapy for this condition.To compare the efficacy, safety, and tolerability of botulinum toxin type A (BtA) versus placebo in people (...) was improvement in cervical dystonia-specific impairment. The primary safety outcome was the proportion of participants with any adverse event.We included eight RCTs of moderate overall risk of bias, including 1010 participants with cervical dystonia. Six studies excluded participants with poorer responses to BtA treatment, therefore including an enriched population with a higher probability of benefiting from this therapy. Only one trial was independently funded. All RCTs evaluated the effect of a single BtA

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2017 Cochrane

13. Ataxia Telangiectasia Gene Mutation in Isolated Segmental Dystonia Without Ataxia and Telangiectasia (PubMed)

Ataxia Telangiectasia Gene Mutation in Isolated Segmental Dystonia Without Ataxia and Telangiectasia https://onlinelibrary.wiley.com/page/journal/23301619/homepage/mdc312564-sup-v001_1.htm.

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2017 Movement disorders clinical practice

14. Deep Brain Stimulation for the Dystonias: Evidence, Knowledge Gaps, and Practical Considerations (PubMed)

Deep Brain Stimulation for the Dystonias: Evidence, Knowledge Gaps, and Practical Considerations Deep brain stimulation (DBS) of the globus pallidus internus (GPi-DBS) is among the most effective treatment options for dystonias. Because the term "dystonia" is defined by a characteristic phenomenology of involuntary muscle contractions, which may present with a large clinical and pathogenetic heterogeneity, decision making for or against GPi-DBS can be difficult in individual patients.A search (...) of the PubMed database for research and review articles, focused on "deep brain stimulation" and "dystonia" was used to identify clinical trials and to determine current concepts in the surgical management of dystonia. Patient selection in previous studies was recategorized by the authors using the new dystonia classification put forward by a consensus committee of experts in dystonia research. The evidence and knowledge gaps are summarized and commented by the authors taking into account expert opinion

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2017 Movement disorders clinical practice

15. Validation of the XDP–MDSP rating scale for the evaluation of patients with X-linked dystonia-parkinsonism (PubMed)

Validation of the XDP–MDSP rating scale for the evaluation of patients with X-linked dystonia-parkinsonism X-linked dystonia-parkinsonism(XDP) is a neurodegenerative disorder endemic to the Philippines. A rating scale was developed by the authors under the guidance of the Movement Disorder Society of the Philippines (MDSP) to assess XDP severity and progression, functional impact, and response to treatment in future clinical trials. Our main objective was to validate our new scale, the XDP (...) -MDSP scale. The initial validation process included pragmatic testing to XDP patients followed by a modified Delphi procedure with an international advisory panel of dystonia, parkinsonism and scale development experts. Pearson correlation was used to assess construct validity of our new scale versus the assess construct validity of our new scale versus standard dystonia, parkinsonism, non-motor and functional scales; and also to assess divergent validity against behavioral and cognitive scales

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2017 NPJ Parkinson's disease

16. Providing an imputation algorithm for missing values of longitudinal data using Cuckoo search algorithm: A case study on cervical dystonia (PubMed)

Providing an imputation algorithm for missing values of longitudinal data using Cuckoo search algorithm: A case study on cervical dystonia Missing values in data are found in a large number of studies in the field of medical sciences, especially longitudinal ones, in which repeated measurements are taken from each person during the study. In this regard, several statistical endeavors have been performed on the concepts, issues, and theoretical methods during the past few decades.Herein, we (...) focused on the missing data related to patients excluded from longitudinal studies. To this end, two statistical parameters of similarity and correlation coefficient were employed. In addition, metaheuristic algorithms were applied to achieve an optimal solution. The selected metaheuristic algorithm, which has a great search functionality, was the Cuckoo search algorithm.Profiles of subjects with cervical dystonia (CD) were used to evaluate the proposed model after applying missingness

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2017 Electronic physician

17. The Frequency and Self‐perceived Impact on Daily Life of Motor and Non‐motor Symptoms in Cervical Dystonia (PubMed)

The Frequency and Self‐perceived Impact on Daily Life of Motor and Non‐motor Symptoms in Cervical Dystonia Evidence suggests that non-motor symptoms (NMS) are the most important predictors of decreased health-related quality of life (HR-QoL) in patients with cervical dystonia (CD). In this study, we evaluate an NMS screening list and examine the influence of motor symptoms and NMS on HR-QoL.In 40 patients with CD, the frequency of NMS was evaluated using an extended NMS questionnaire (...) . Several domains of HR-QoL were significantly influenced by NMS, whereas motor symptoms had only a small influence on the physical functioning domain of HR-QoL.Our findings highlight the impact of NMS on HR-QoL and emphasize the importance of a standardized, validated NMS questionnaire for patients with dystonia. This would enable us to monitor the effect of treatment for motor symptoms and NMS on an individual basis and improve treatment options.

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2017 Movement disorders clinical practice

18. A History of Dystonia: Ancient to Modern (PubMed)

A History of Dystonia: Ancient to Modern Before 1911, when Hermann Oppenheim introduced the term dystonia, this movement disorder lacked a unifying descriptor. While words like epilepsy, apoplexy, and palsy have had their meanings since antiquity, references to dystonia are much harder to identify in historical documents. Torticollis is an exception, although there is difficulty distinguishing dystonic torticollis from congenital muscular torticollis. There are, nevertheless, possible (...) representations of dystonia in literature and visual art from the pre-modern world. Eighteenth century systematic nosologists such as Linnaeus, de Sauvages, and Cullen had attempted to classify some spasmodic conditions, including torticollis. But only after Charcot's contributions to clinical neuroscience were the various forms of generalized and focal dystonia clearly delineated. They were categorized as névroses: Charcot's term for conditions without an identifiable neuroanatomical cause. For a time

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2017 Movement disorders clinical practice

20. Fatigue, Sleep Disturbances, and Their Influence on Quality of Life in Cervical Dystonia Patients (PubMed)

Fatigue, Sleep Disturbances, and Their Influence on Quality of Life in Cervical Dystonia Patients Nonmotor symptoms (NMS) are highly prevalent in cervical dystonia (CD). In general, fatigue and sleep are important NMS that determine a decreased health-related quality of life (HR-QoL), but their influence in CD is unknown. The authors systematically investigated fatigue, excessive daytime sleepiness (EDS), and sleep quality in patients with CD and controls and assessed the influence (...) of psychiatric comorbidity, pain, and dystonia motor severity. They also examined the predictors of HR-QoL.The study included 44 patients with CD and 43 matched controls. Fatigue, EDS, and sleep quality were assessed with quantitative questionnaires and corrected for depression and anxiety using analysis of covariance. The Toronto Western Spasmodic Torticollis Rating Scale and the Clinical Global Impression Scale-jerks/tremor subscale were used to score motor severity and to assess whether motor

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2016 Movement disorders clinical practice