Medical treatment of dystonia

Medications such as anticholinergic drugs, dopamine modulators, baclofen, muscle relaxants, and other pharmacologic agents have been used for a long time to treat dystonia, but the introduction of botulinum toxin and deep brain stimulation clearly revolutionized the symptomatic treatment of this neurological movement disorder. Therapy of dystonia can be divided into the following categories: (1) physical, supportive, and ancillary therapy; (2) pharmacologic treatment; (3) chemodenervation with botulinum toxin; and (4) peripheral and central surgery (deep brain stimulation). Except in some cases of secondary dystonia, pathogenesis-targeted or disease-modifying therapy is currently not available. This review focuses on evidence-based medical treatment of dystonia, highlighting recent advances, with emphasis on individualized approach. (C) 2013 Movement Disorder Society