Source:

Nursing2015

August 2007, Volume 37 Number 8 , p 31 - 31 [FREE]

Author

  • Terrilynn Fox Quillen RN, BS

Abstract

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Quillen, Terrilynn Fox RN, ...

 

MYTH: Dystonia is an acquired neuromuscular disorder.

 

FACT: Dystonia is a term that describes involuntary movement disorders characterized by sustained, repetitive muscle contractions. Most patients with dystonia have primary (idiopathic) dystonia: For unknown reasons, the basal ganglia, which control movement, don't function properly. Causes of secondary or acquired dystonia include brain tumors, multiple sclerosis, Parkinson's disease, carbon monoxide poisoning, or an overdose of antipsychotic medication.

 

MYTH: The rapid, rhythmic intermittent movements of dystonia occur randomly over the entire body.

 

FACT: The pattern of abnormal movement varies. Generalized dystonia can affect most or all of the body; focal dystonia is limited to specific muscle groups or a single body part. Segmental dystonia affects contiguous body areas, hemidystonia affects one side of the body, and limb dystonia affects the arms or legs and is triggered by specific tasks, such as writing or walking.

 

MYTH: Tics are the most commonly observed form of dystonia.

 

FACT: Although ticlike twitching can occur, dystonia is more commonly characterized by sustained muscle contractions that result in repetitive patterned movement and abnormal body posture. Trismus (jaw spasms that prevent the patient from opening his mouth fully) and torticollis (neck spasms that can put the patient's head in an abnormal position) are two common features of dystonia affecting the upper body.

 

MYTH: Skeletal muscle relaxants are the drugs of choice for treating dystonia.

 

FACT: Treatment depends on the origin and type of dystonia. Acute secondary dystonia caused by neuroleptic agents is treated by discontinuing the offending drugs and administering anticholinergics or benzodiazepines. Primary dystonia can be treated with injections of botulinum toxin and drugs such as levodopa-carbidopa.

MYTH: Dystonia is an acquired neuromuscular disorder.

FACT: Dystonia is a term that describes involuntary movement disorders characterized by sustained, repetitive muscle contractions. Most patients with dystonia have primary (idiopathic) dystonia: For unknown reasons, the basal ganglia, which control movement, don't function properly. Causes of secondary or acquired dystonia include brain tumors, multiple sclerosis, Parkinson's disease, carbon monoxide poisoning, or an overdose of antipsychotic medication.

MYTH: The rapid, rhythmic intermittent movements of dystonia occur randomly over the entire body.

FACT: The pattern of abnormal movement varies. Generalized dystonia can affect most or all of the body; focal dystonia is limited to specific muscle groups or a single body part. Segmental dystonia affects contiguous body areas, hemidystonia affects one side of the body, and limb dystonia affects the arms or legs and is triggered by specific tasks, such as writing or walking.

MYTH: Tics are the most commonly observed form of dystonia.

FACT: Although ticlike twitching can occur, dystonia is more commonly characterized by sustained muscle contractions that result in repetitive patterned movement and abnormal body posture. Trismus (jaw spasms that prevent the patient from opening his mouth fully) and torticollis (neck spasms that can put the patient's head in an abnormal position) are two common features of dystonia affecting the upper body.

MYTH: Skeletal muscle relaxants are the drugs of choice for treating dystonia.

FACT: Treatment depends on the origin and type of dystonia. Acute secondary dystonia caused by neuroleptic agents is treated by discontinuing the offending drugs and administering anticholinergics or benzodiazepines. Primary dystonia can be treated with injections of botulinum toxin and drugs such as levodopa-carbidopa.

RESOURCES

 

Grosset K, Grosset D. Prescribed drugs and neurological complications. Journal of Neurology, Neurosurgery & Psychiatry. 75(Suppl. 3):iii2-iii8, September 2004.

 

Lynn D, et al. The 5-Minute Neurology Consult. Philadelphia, Pa., Lippincott Williams & Wilkins, 2004.