Treatment of dystonia

summary

Dystonia is a dyskinesia syndrome characterized by dystonic movements and postures, which is caused by uncoordinated or excessive contractions of active and antagonistic muscles. It will have a great impact on the life of patients. I visited a friend with dystonia a few days ago. Through the communication with the doctor, I learned some knowledge about the disease. Let's share it with you.

Treatment of dystonia

First: the treatment of dystonia, in drug treatment methods, you can choose: 1, anticholinergic drugs. Given the maximum tolerable dose of benhexol 20 ~ 30mg / D, oral 3 ~ 4 times, may control symptoms, but the general adverse reactions are obvious. 2. Diazepam 2.5 ~ 5mg, nitrazepam 5 ~ 7.5mg or clonazepam 1 ~ 2mg, 3 / D, is effective in some cases, especially clonazepam is the most effective in patients with paroxysmal dystonia chorea hand foot bradycardia. 3. Haloperidol, phenothiazines or bubenazine may be effective, but when the effective dose is reached, mild Parkinson's syndrome may be induced. 4. Levodopa has a dramatic effect on dopa responsive dystonia. Long term treatment does not need to increase the dose. 5. Baclofen and carbamazepine may also be effective. The patients with secondary dystonia should be treated with primary disease at the same time. 6. Phenytoin sodium 0.1g, 3 / D, is effective for most patients with paroxysmal dystonia. Acetazolamide or adrenocortical hormone may be effective in these patients. 7. Selective serotonin reuptake inhibitor (SSRI). For dystonia patients with mental stimulation factors, SSRI can be added, such as fluoxetine, paroxetine, sertraline and citalopram.

Second: in drug treatment, botulinum toxin type a can also be injected. According to experts, local injection has better curative effect. The injection site is the muscle with the most severe spasm or the muscle group whose electromyography shows obvious abnormal discharge. For example, for spasmodic torticollis, four of the three pairs of muscles, such as sternocleidomastoid muscle, cervical splinter muscle and trapezius muscle, can be injected at multiple points; blepharospasm and oromandibular dystonia The patients with laryngeal dystonia were divided into adductor type, abductor type and posterior cricoarytenoid type. Writing spasm injections into affected muscles can sometimes help. The dose of the above application should vary with different individuals. The effective rate was 70%. The effect lasted for 3 months. Repeated injection was effective.

Third: in the surgical treatment, the methods are: 1. Peripheral surgery: for patients with severe spasmodic torticollis, the accessory nerve and upper cervical nerve root can be cut off, some cases can relieve symptoms, but can recur. ② Thalamic lesion or deep brain stimulation: it may be effective for some unilateral and systemic dystonia. From a small number of research results show that the curative effect is fair, and the improvement of limb symptoms is better than that of trunk.

matters needing attention

The harm of dystonia is great. It has psychological harm and physical influence on patients. Dystonia patients need active treatment, do not go without treatment, otherwise it will become more and more serious.