Dystonia (muscle cramp) - Treatment

Options consist of medical therapy in rehabilitation therapy, oral medications, and surgical interventions neurochemolitice. Dystonia are often triggered or exacerbated by fatigue, anxiety, relaxation or sleep, intentional movements. Specific massage, light stretching and ultrasound techniques and biofeedback are sometimes helpful in people with focal dystonia or regional.
Rehabilitation therapy.Dystonia may be influenced by relaxation or fatigue, and attention to environmental factors and those stressors are controllable condition. Some dystonic movements can take seconds or minutes, while others can last hours or weeks. perpenente can lead to contractures, bone deformity or significant impairment of motor function. It is practical to prevent joint contractures cleft abnormalities extended to stabilize and reduce movement orthopedic deformities. Physical therapy massage, light stretching and ultrasound with biofeedback are sometimes helpful for people with focal dystonia or regional. Patients with generalized dystonia often benefit through training to deploy.Several psychiatric therapies and modalities have been used with limited success to treat dystonia. These include relaxation techniques, sensory stimulation, biofeedback, transcutaneous electrical nerve stimulation and percutaneous stimulation of the spinal dorsal. Logopezii can provide special training and communication techniques oromandibulara and laryngeal dystonia.
Medical therapy.Medications can be helpful introduction to some extent in controlling dystonia, but the lack of accurate knowledge on the pathology of their specific pharmacologic therapy is difficult.Systemic administration of cholinergic therapies include benzodiazepines, antiparkinson, lithium, baclofen, anticonvulsants.Successful pharmacologic therapy involves administration of drug combinations.Intrathecal baclofen administered by an implanted pump can be very effective for certain types of SITON, especially if the shows and spasticity. The benefits of this drug is low prevalence of adverse effects when administered in cerebrospinal fluid can continuously release the drug and the possibility to test the therapeutic effect.
Neurochemolitica therapy or muscle blocks.Neurochemoliza dystonic muscle is an important therapeutic option. Injections of botulinum toxin or phenol / alcohol have become powerful tools in the symptomatic relief of focal dystonia.This reduces the ability of muscles to contract. Botulinum toxin is produced by gram-negative bacteria Clostridium botulinum and acts by inhibiting the presynaptic release of acetylcholine at the neuromuscular junction. The onset of effect requires several days after injection.Injection of botulinum toxin in the muscle reduces muscle contractions for 3 months. It is associated with complications, although dysphagia and dry mouth may occur. The drug can be effectively used for years. Phenol and alcohol blocks the nerve temporarily, but their effects are related six months and cheaper.
Surgical therapy.Surgical options for dystonia include persistent severe spinal accessory nerve transsectia for torticollis, or palidotomia stereotactic talamotomia for generalized dystonia and muscle excision. Because the risk of significant comorbidity such options are reserved for patients with debilitating dystonia after other therapies have failed.
Deep brain stimulation.It is an investigative therapy for severe dystonia. The best results were obtained by stimulating palidusului in patients with primary generalized dystonia. side effects and long-term effectiveness is unknown. require stereotactic placement of electrodes in the brain.
Prognosis.Functional impact of dystonia varies from barely notifiable until severe disability. Dystonia may have a profound effect on personal and emotional life of his patient and the possibility of being independent. Focal dystonia such as torticollis and blepharospasm may worsen after a few years before stabilizing. It may improve or disappear spontaneously. In some cases dystonia returns after a break. Focal dystonia does not extend to become generalized. If dystonia develops in childhood are at risk of becoming generalized. This type of dystonia is more debilitating than the adult form.