Dystonia: Treatments

There are many therapeutic leads, depending on the case, but not a particular drug. Each person reacts differently. Several attempts are often necessary before finding the most appropriate treatment.

1 - Medication treatments
Most drugs used, act on neuromediators of the nervous system.
> Muscle relaxants: they relax muscles and relieve cramps.
> Anticholinergics: they reduce the effects of acetylcholine, a neuromediator of the nervous system.
> Benzodiazepines: they act on anxiety and relieve painful spasms.

2 - Botulinum injections
Botulinum toxin (botulinum toxin) is the standard treatment for focal dystonia. It has been used for more than 25 years in this indication (and therefore not only for aesthetic medicine against wrinkles!). Botulinum toxin has the effect of paralyzing the muscles that work too much, temporarily. Injected into the affected muscles, those who contract uncontrollably, botulinum toxin helps reduce excessive contraction. The product acts effectively on the consequence of the disease but not on its cause.

3 - Physiotherapy
Physiotherapeutic treatment consists of strengthening muscles that do not work enough. Those who are the opposite of the contraction. The goal: to recover the natural axis, when it is a torticollis and recover the amplitude of rotation of the head.

Physiotherapy is essential in the treatment of some dystonias, but not all: in the case of blepharospasm, it is useless. Physiotherapy prevents stiffness from becoming permanent.

The work with the physiotherapist is in the long term. And, most of the time, exercises are to be done at home: it is self-reeducation.

4 - A surgical operation
Surgical treatment may be considered, even if it is reserved for very specific cases of generalized dystonia. Two kinds of surgical treatments are possible:
> It can be a question of denervation of some muscles too active (one withdraws the nerve fibers of certain muscular groups).

> It may involve implanting small electrodes into the brain that will block the abnormal activity of the brain structures involved in the dystonia by electrical stimulation. The electrode is connected to a neuro-stimulator usually implanted under the skin, near the clavicle or at the level of the abdomen. This treatment is reversible since this electrical stimulation system can be turned off or removed.

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