Rehabilitation for Functional Dystonia: Cases and Review of the Literature.

Autor: Gros P; Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Department of Medicine, Division of Neurology, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada., Bhatt H; Integrated Movement Disorders Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada., Gilmour GS; Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Department of Medicine, Division of Neurology, Toronto Western Hospital and the University of Toronto, Toronto, Ontario, Canada.; Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada., Lidstone SC; Integrated Movement Disorders Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2024 Aug; Vol. 11 (8), pp. 1018-1024. Date of Electronic Publication: 2024 Jun 09.
DOI: 10.1002/mdc3.14121
Abstrakt: Background: Functional dystonia (FD) is a common subtype of functional movement disorder. FD can be readily diagnosed based on positive signs and is potentially treatable with rehabilitation. Despite this, clinical outcomes remain variable and a gold standard approach to treatment is lacking.
Cases: Here we present four cases of axial and limb functional dystonia who were treated with integrated rehabilitation and improved. The therapy approach and clinical outcomes are described, including videos.
Literature Review: A literature review evaluated the published treatment strategies for the treatment of functional dystonia. Out of 338 articles, 25 were eligible for review and included mainly case reports and case series. Most patients received more than one treatment modality. Non-invasive therapies, commonly physiotherapy and psychological approaches were mostly associated with positive outcomes. Multiple treatments commonly used in dystonia were used, including botulinum toxin injections, pharmacotherapy and surgery, leading to variable outcomes.
Conclusion: Therapy should be personalized to the clinical presentation. In challenging cases, initiation of a multidisciplinary approach may provide benefit regardless of etiology. Pharmacotherapy should be used judiciously, and surgical therapy should be avoided.
(© 2024 The Author(s). Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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