Acknowledgement
We would like to acknowledge use of information taken from The Parkinson’s Disease Society (UK) information sheet ‘Muscle Cramps and Dystonias '.
For treatment to be effective, it is essential to understand the trigger or cause of the dystonia. Certain drugs may be effective for some people but not for others. Some drugs work by interfering with neurotransmitters and disrupting the messages sent to muscles by the brain. Others work by relaxing the muscles and so reduce shaking and aid control of muscle spasms.
Depending on the cause and severity of the dystonia, the strategies that the doctor may suggest include:
If the dystonia is levodopa-related, it is a good idea to keep a ‘motor diary’ to record when dystonic spasms occur and how they relate to the timing of medications. Your doctor should then be able to help in adjusting dosage and/or timings to manage your dystonia. For more information on such diaries, see www.epda.eu.com/patientGuide/D_WearingOffDiary.shtm
CAUTION! As with all medications, you should always discuss changes with your doctor before altering your dosage or how you take it.
Most people have never heard of dystonia - even though The Dystonia Society estimates it to be about ten times more common than motor neurone disease.
Chemicals, such as dopamine and acetylcholine, which are made in the brain and send messages between different nerve cells.
The main type of drug prescribed to treat Parkinson's disease and has been in use since the late 1960s. The aim is to increase the levels of dopamine in the brain. Dopamine cannot be directly replaced because it cannot cross the blood-brain barrier that prevents potentially harmful substances in the blood from entering the brain. Levodopa is a chemical compound that can cross this barrier and is then converted into dopamine.
See also Types of medication available.
A class of drugs that work by stimulating the parts of the brain (know as dopamine receptors ) where dopamine works. Unlike levodopa, they don’t need to be converted by the brain cells first. They may be given as a first treatment to delay the need for levodopa or used in combination with levodopa to treat the side effects caused by long-term treatment.
See also Types of medication available.
Medications used to treat muscular tension and pain.
This group of drugs are also known as tranquillisers and sedatives.
Benzodiazepines work by slowing down the transmission of nerve signals in the brain to central nervous system.
A class of older drugs that are used to treat Parkinson's. They work by reducing the amount of acetylcholine in the body and thereby facilitate dopamine cell function.
Also called antimuscarinics.
See also Types of medication available.
A neurotoxin used in minute doses as a treatment for muscle spasms and dystonia.
A treatment option for people with advanced Parkinson's disease. It uses one or two surgically implanted medical devices called neurostimulators, similar to cardiac pacemakers, to deliver electrical stimulation to precisely targeted areas on each side of the brain. This is commonly called deep brain stimulation. Stimulation of these areas appears to block the signals that cause the disabling motor symptoms of Parkinson's. As a result, many patients achieve greater control over their body movements.
See section on Deep Brain Stimulation [DBS].
A surgical operation in which a specific groups of cells within the thalamus that controls some involuntary movements is surgically destroyed.
Before surgery, detailed brain scans using a CT scan or MRI are done to identify the precise location for treatment. This procedure is often poorly tolerated because of increased complication and risk, including vision and speech problems. The positive effects on tremor are immediate. Other less destructive procedures are preferred, such as subthalamic deep brain stimulation (DBS), since this procedure can also improve tremor and other symptoms of Parkinson's disease.
Pallidotomy is a surgical operation where a tiny electrical probe is placed in the globus pallidus internus (GPi), one of the basal ganglia of the brain involved with the control of movement, in order to destroy a small area of brain cells. This reduces the brain activity in that area, which may help relieve motor symptoms such as tremor and stiffness (rigidity ).
Before surgery, detailed brain scans using MRI are carried out to identify the precise location for treatment. The probe heats surrounding tissue by emission of radio waves and the heat destroys nearby tissue.
Until the late 1990s, pallidotomy was the most common type of Parkinson's disease surgery. Doctors now rarely perform pallidotomy due to risks involved. Instead, doctors use deep brain stimulation, a procedure that does not destroy brain tissue and has fewer risks than pallidotomy.
A neurotransmitter that sends messages between nerve cells or muscles and nerve cells.
Having to do with the movement of a part of the body.
An important system in the body that involves the brain, spine and the nerves. Responsible for the body’s contacts and responses to the external world and also its internal communication.
See also Central Nervous System
