What is your approach to the management of worsening dystonic spasms that are painful and refractory to standard dystonia medications?  

In a patient who is already on a standing regimen of baclofen, tizanidine, trihexyphenidyl, clonidine, and diazepam and who is taking additional diazepam and tizanidine as needed for the painful spasms. 

Answer from: at Academic Institution

Answer from: at Community Practice