Topics:
Neurology • Movement disorders
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
If the problematic area of dystonia is focal, botulinum toxin treatment should be considered which is the treatment of choice for focal dystonia.
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Answer from: at Community Practice
Agree with Dr. @Siddiqui, my friend.
I would also add physical therapy specifically asking for a muscle mobilization therapist within a week after chemodenervation.
Physical therapy really helps after treatment or without treatment.
Also, set realistic expectations about pain management: remind o...