Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dystonia may be classified by age of onset (childhood, adolescence, adult onset), body distribution of the abnormal movements (focal, segmental, unilateral, multifocal and generalized) and etiology (idiopathic and symptomatic). We studied 76 patients with idiopathic dystonia among 122 cases of dystonic syndrome (62.3% of the total). There were 48 female and 28 male patients. Adult-onset focal dystonia was the most frequent feature (37 patients). The onset of generalized dystonia was more frequently seen under the age of 20, whereas focal and segmental dystonia usually started over this age. Postural tremor of the hands was observed in 19.7% of the patients. Spasmodic torticollis was the most prevalent form of dystonia overall. Except for writer's cramp, which occurred more frequently in males, and generalized dystonia, which was equally divided between sexes, all other forms were more frequent in females. Our data suggest that differences in racial origin, social and economical status and environmental factors do not account for a different manifestation in dystonia pattern.
 ...
PMID:Idiopathic dystonia. Clinical profile of 76 Brazilian patients. 130 50

Spasmodic torticollis is classified as a focal dystonia. It is characterized by involuntary contractions of the muscles of the neck, with consequent deviation of the head from the correct posture. Psychological factors are recognized as important trigger and aggravating mechanisms. The various possibilities of therapeutic management (medical and surgical treatment, psychological methods and psychotherapy) are reviewed. Therapy of spasmodic torticollis should be started with methods such as biofeedback, behaviour therapy, and anticholinergic drugs. If these procedures not successful, local application of botulinum toxin offers a new and highly effective technique. Surgical treatment such as neurotomy, rhizotomy, or stereotaxic operations should be restricted to otherwise intractable cases.
 ...
PMID:[Therapeutic possibilities in spasmodic torticollis]. 201 11

Botulinum A toxin injection is the most recent and effective treatment of various movement disorders especially focal dystonia. Spasmodic torticollis is one focal dystonia which responds poorly to both medication and surgery. Botulinum A toxin injection has been adopted as a treatment procedure at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand since 1989 (before the American Food and Drug Administration approval) as a research protocal for Thai patients. This report is the first ever study of this treatment for Thai patients with spasmodic torticollis. Fifty six spasmodic torticollis patients who had been treated with botulinum A toxin injection at the Movement Disorder Clinic, Siriraj Hospital were analysed. Thirty six patients were male and the male to female ratio was 1.8:1. Most of the patients (76.79 per cent) were aged between 20-49 years and half of them were from Bangkok. Twelve patients (21.43 per cent) were classified as simple torticollis, 35 patients (62.5 per cent) were combined torticollis, 7 patients (12.5 per cent) were retrocollis, and 2 patients (3.57 per cent) were lateral collis. Three patients had generalised dystonia and 2 patients had segmental dystonia. Duration of suffering in each patient ranged from 1 month to 25 years with the mean duration of 3.70 (S.D. 5.09) years. Only four patients (7.14 per cent) refused botulinum A toxin injection due to their mild symptoms. The remaining 52 patients were given botulinum A toxin injection of 30-120 international units into the most overactive group of muscles which were responsible for abnormal neck posture (mainly sternocleidomastoid and splenius capitis). Eight patients (15.38 per cent) were lost to follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Botulinum A toxin treatment in spasmodic torticollis: report of 56 patients. 770 65

Local injections of botulinum toxin constitute the only truly effective treatment of certain abnormal movements and focal dystonias. The authors describe its indications and report on their personal experience. One hundred and seventeen patients were treated: 48 for blepharospasm, 46 for hemifacial spasm and 23 for spasmodic torticollis. The results were evaluated by means of a score taking into account the effectiveness of treatment, the duration of this effectiveness, the side-effects, if any, observed, and the course of the neurological disorder after several series of injections. The results were good or excellent in 91 percent of patients with hemifacial spasm and 79 percent of patients with blepharospasm. Spasmodic torticollis was much improved in 35 percent of the cases and less, but satisfactorily, improved in 48 percent. In this disease, the muscles which antagonize those responsible for the dystonia must absolutely be re-educated.
 ...
PMID:[Treatments by local injections of botulinum toxin in neurology. Indications and results]. 836 20

Seventy-six consecutive patients with cervical dystonia. (CD) treated with botulinum toxin were assessed with the Tsui rating scale, the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), and a global scale of improvement. Tsui, TWSTRS, and TWSTRS subscale scores all showed significant improvement. Tsui and TWSTRS score reduction rates correlated significantly with each other, and each correlated with the global scale. Analysis of these scales and TWSTRS subscales indicates that an objective scale of severity such as either the Tsui rating scale or TWSTRS severity subscale used in conjunction with the TWSTRS pain subscale adequately assesses improvement of CD following treatment with botulinum toxin.
 ...
PMID:Comparison of clinical rating scales in treatment of cervical dystonia with botulinum toxin. 899 61

Spasmodic torticollis (cervical dystonia) is frequently a painful condition but little is known of the characteristics of the pain. We assessed 39 patients with spasmodic torticollis for the presence or absence, location, and quality of pain, as well as its correlation to postural abnormality. Muscle tenderness was evaluated by manual palpation and pressure algometry. Measurements were made on muscles either actively maintaining or opposing abnormal head posture, as well as on muscles not contributing to it. Control measurements were made in 18 healthy subjects. Two-thirds of patients reported continuous or intermittent recurrent pain. Pain was reported widespread and diffuse over the neck and shoulders, with some radiation, predominantly on the side toward which the head was twisted. There were no differences between study groups when compared for pressure algometry and only moderate differences when compared for manual palpation. No correlation was found between the severity of motor signs and pain. Degenerative changes seen on X-rays were similar in painful and pain-free patients. These findings suggest that pain associated with spasmodic torticollis does not arise in muscles alone, and we hypothesise that central mechanisms are also involved.
 ...
PMID:Pain in spasmodic torticollis. 908 2

The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) assesses the character and severity of cervical dystonia (CD). We developed a teaching tape of the TWSTRS scoring for the motor symptoms of CD. The tape provides investigators with visual representations of each component of the motor section of the TWSTRS as agreed upon by three independently scoring raters. The rate of agreement for the nondichotomous components was always significant, with a Kendall's coefficient of concordance W ranging between 0.98 and 0.76 (p < 0.01 for all measures). For the two dichotomous components, a weighted kappa coefficient was also significant at 0.86 for lateral shift and 0.89 for sagittal shift (p < 0.01 for both measures). Scale deficiencies identified by the raters were an explicit definition of midline for assessment of range of motion, the absence of a separate scoring category assessing dystonic tremor, and the specification of duration for the effect of sensory tricks. These observations should be taken into account in future revisions of the TWSTRS and in refinements of other rating scales for CD.
 ...
PMID:Teaching tape for the motor section of the Toronto Western Spasmodic Torticollis Scale. 925 Oct 76

We enrolled and treated 122 patients with idiopathic cervical dystonia in a double-blind, placebo-controlled safety and efficacy study of botulinum toxin type B (BotB). Both A-responsive and A-resistant patients were enrolled. Patients received intramuscular injections of either BotB (2,500 U, 5,000 U, or 10,000 U) or placebo. The primary outcome measure of efficacy was the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)-Total score at 4 weeks following study drug administration. Secondary measures of efficacy were TWSTRS-Severity, -Disability, and -Pain subscale scores, and Analog Pain Assessment, Investigator Global Assessment, Patient Global Assessment, and Sickness Impact Profile scores. Duration of effect was estimated with an intent-to-treat analysis of responders. Safety measures included clinical parameters, laboratory tests, and adverse events. The primary and most of the secondary analyses indicated a statistically significant treatment effect and a dose response. BotB is safe, well tolerated, and efficacious in the treatment of cervical dystonia at the doses tested.
 ...
PMID:Botulinum toxin type B: a double-blind, placebo-controlled, safety and efficacy study in cervical dystonia. 930 26

Botulinum toxin (BTX) injection is considered the treatment of choice for patients with cervical dystonia (torticollis). We conducted a pilot, open-label, dose-escalation study with BTX type B in 12 patients who no longer responded clinically to injections with BTX type A. At the doses tested, BTX type B was safe and well tolerated without evidence of dose-limiting toxicity in this patient population. Mild-to-moderate adverse events generally resolved quickly and included asthenia, pain, nausea, dysphagia, hypertonia, and tremor. No serious adverse events or antibodies to type-B treatment were reported. Low-dosing-session (100-899 units) and high-dosing-session (900-1,500 units) groups were defined based on units administered per dosing session. Toronto Western Spasmodic Torticollis Rating Scale-Severity Scale (TWSTRS-Severity), Patient Analogue Pain Scale, and Physician and Patient Global Assessment Scales were measured during this study. The TWSTRS-Severity mean maximum percent improvement from baseline demonstrated a 9.9% versus 28.8% difference between the low-dose and high-dose groups, respectively. EFfectiveness was noted for the high-dose group on the Patient Analogue Pain Scale but not on the Global Assessment Scales.
 ...
PMID:BotB (botulinum toxin type B): evaluation of safety and tolerability in botulinum toxin type A-resistant cervical dystonia patients (preliminary study). 938 65

There are 3 clinical groups of dystonia: generalized, segmental and focal. Spasmodic torticollis, blepharospasmus, laryngeal dystonia and graphospasmus belong to the focal dystonia. The aetiology of dystonias is not clear but genetic factors are commonly accepted. Treatment with pharmacological and surgical methods is not satisfactory. Botulinum toxin A(BTX) has brought a new approach to the effective treatment of dystonias. Effectiveness of this method is estimated as 60 to 100%, depending on clinical factors, department and author. BTX acts on neuro-muscular junction and produces chemical denervation but the effect is not persistent and after 3 or more months the treatment should be repeated. The method is harmless and can be administered in out-patients practice. Adverse events are observed in 10% patients but they are not serious and transient. Details are described the methods of BTX injections in spasmodic torticollis, blepharospasmus and laryngeal dystonia.
 ...
PMID:[Botulinum A toxin in the treatment of focal dystonias]. 960 51


1 2 3 4 5 6 7 Next >>