Dystonia – a Case Study Describing and Analyzing the Effects of Dystonia Essay Example

(1858-1919); He opened a centre for clinical neurology in 1980 and wrote information on brain tumours and syphilis of the brain. In 1911 Oppenheim invented the term ‘Dystonia muscular in deformans’; the term Dystonia is used regularly in modern times. Before the Dystonia genes were discovered, the word idiopathic was commonly used to illustrate the forms of the disorder that were assumed to be genetic.

Through the years Dystonia has been connected to many forms of movement disorder and treatment has become more available. o diagnose someone with Dystonia, a physician must use methods of analysis such as the patients history, family history, blood and urine tests, analysis of the cerebrospinal fluid, electrical recoding techniques (electromyography – EMG or electroencephalography – EEG), genetic testing (for the specific forms of Dystonia and other tests and screenings to rule out the possibility of other conditions or disorders. The most recommended type of physician to diagnose a person with Dystonia is called a movement disorder neurologist.There are many different opinions on the most appropriate form of treatment for Dystonia, but there are six main treatments commonly used by people. These treatments involve oral medications, injection therapy, intrathecal medications, deep brain stimulation, ablative surgery and complementary therapies.

Oral medications are pharmacological (drug) treatments for Dystonia such as Baclofen, Dopamine-blocking, Benzodiazepine, Dopamine-depleting agents or anti-cholinergics, and they may also be combined with other treatments.The drugs can often cause side-effects although they may create benefits for the person’s medical state as well and should not be used without doctor approval. Injection therapy uses a toxin or toxic protein called Botulinum (produced by the bacterium clostridium Botulinum) and is usually treatment for

people with severe Dystonia who have not responded properly to other drug treatments due to side effects or the tolerance of the patient’s body. The toxin is injected into the effected muscle causing it to relax, decrease in unwanted movement and revert back to a more regular position or form.Intrathecal medications (drugs) are used in the treatment for secondary Dystonia and for people with severe Dystonia who have not responded properly to other drug treatments due to side effects or the tolerance of the patients body; the drug is injected into the area around the spinal cord (called the intrathecal space) by using a three part system - a surgically placed, programmable pump containing a holding area for the drug, a flexible tube made of silicone and a programming device.

Deep brain stimulation or DBS involves drilling two surgically placed holes into the skull where wires are inserted and funnelled down the neck and connected to a pacemaker imbedded in the patient’s chest which sends electrical impulses to the targeted areas of the brain. The impulses change the brain waves being produced into normal, constructive signals so that the brain will function more efficiently.This form of treatment is extremely dangerous as there is a large risk of infection or accidental puncture of the brain and the pace maker may malfunction, but deep brain stimulation has a very positive affect on even the most severe cases of Dystonia. Ablative surgery is used to ‘tear down’ a certain select part of the brain.There are many types of ablative surgery, these being Pallidotomy and Thalamotomy (leisioning or surgical destruction of specific brain cells commanding the instigation and growth or

generation of movement), selective Myectomy or Myotomy (where a piece or portion of an over stimulated muscle is separated and taken out of the brain), Ramisectomy and Rhizotomy (the cutting of nerves that are directing an over stimulated or overactive muscle) and or Peripheral de-nervation (the removal of certain nerves right at the area where they enter the hyperactive muscle).Very few people with Dystonia use any form of ablative surgery because although the outcomes can be quite positive for some, there are many risk factors such as infection, haemorrhage or even death; and infection or haemorrhage can lead to cognitive impairment, swallowing difficulty, visual impairment, seizures and headache (some side affects can improve but may also persist and increase).

Complementary therapies are forms of physiotherapy which usually accompany other forms of treatment for Dystonia.The therapy is used to maintain muscle tone, mobility, strength and co-ordination. Some patients may use exercises called ‘sensory ticks’ which are used to alleviate symptoms. ‘Sensory ticks’ usually consist of touching or stroking a particular area on the skin, it is unknown how this relieves their symptoms but there are theories that the stimulation may disrupt the irregular nerve impulses that cause the overactivity.Dystonia can occasionally make a normal living hard to manage but is not necessarily a crippling disorder.

With the scientific research and treatment available it is possible for a person to become well educated, poses an active and alert mind, fulfil everyday tasks (driving a car, playing sports), have a job, maintain independency, begin and develop relationships and create forms of intimacy with others (marriage, children) if the right medication is used.Dystonia can be treated in all kinds

of ways, and although some doctors prefer certain methods of treatment, it is up to the patient or his/her parents or guardians to decide upon the most appropriate treatment judging by the level of the symptoms and recommended actions of their doctors. The experience of having any form of Dystonia can be sad and or un-nerving at times, but it can never be forgotten that although the disorder does not have a cure, does not also mean that Dystonia cannot be reduced.If a person begins showing signs of Dystonia or already has the disorder then it is important that they seek help or advice from their local general practitioner or GP so that they may be referred to a specialist in the fields of neurology or muscle movement disorders followed by one or more of the many types of treatments available. It is recommended that a person should try medication before undergoing any severe treatment like deep brain stimulation or ablative surgery. References: http://www.

medtronicneuro. com. u, made by Medtronic – managing movement disorders, section: improving life – by controlling involuntary movement, document title: treatment options for Dystonia, last updated: 17th December 2007, Australian site. http://www.

brainaustralia. org. au, made by the brain foundation: brain Australia – an initiative of the brain foundation, section: a-z brain disorders, document title: Dystonia, last updated: September 2008, Australian site. http://www.

dystonia-foundation. org, made by the Dystonia medical research foundation, section: what is Dystonia? , last updated: 2006, Canadian site.