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Cervical Dystonia: From Pathophysiology to Pharmacotherapy
Background: Dystonia is a chronic disorder characterised by an aberration in the control of movement. Sustained co-contraction of opposing agonist and antagonist muscles can cause repetitive and twisting movements, or abnormal postures. Cervical dystonia (CD), often referred to as spasmodic torticol...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214602/ https://www.ncbi.nlm.nih.gov/pubmed/22713419 http://dx.doi.org/10.3233/BEN-2012-120270 |
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author | Patel, Sejal Martino, Davide |
author_facet | Patel, Sejal Martino, Davide |
author_sort | Patel, Sejal |
collection | PubMed |
description | Background: Dystonia is a chronic disorder characterised by an aberration in the control of movement. Sustained co-contraction of opposing agonist and antagonist muscles can cause repetitive and twisting movements, or abnormal postures. Cervical dystonia (CD), often referred to as spasmodic torticollis, is a type of focal dystonia involving the muscles of the neck and sometimes the shoulders. Methods: This systematic review collates the available evidence regarding the safety and efficacy of a range of treatments for CD, focusing on their effectiveness as shown by double-blinded, randomised controlled trials. Results: Our review suggests that botulinum toxin type A (BTA), botulinum toxin type B (BTB) and trihexyphenidyl are safe and efficacious treatments for CD. Evidence shows that botulinum toxin therapies are more reliable for symptomatic relief and have fewer adverse effects than trihexyphenidyl. When comparing BTA to BTB, both are found to have similar clinical benefits, with BTA possibly having a longer duration of action and a marginally better side effect profile. BTB is also safe and probably just as efficacious a treatment in those patients who are unresponsive or have become resistant to BTA. Discussion: The current evidence shows that the pharmacological management of CD relies on BTA and BTB, two agents with established efficacy and tolerability profiles. |
format | Online Article Text |
id | pubmed-5214602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-52146022017-03-23 Cervical Dystonia: From Pathophysiology to Pharmacotherapy Patel, Sejal Martino, Davide Behav Neurol Other Background: Dystonia is a chronic disorder characterised by an aberration in the control of movement. Sustained co-contraction of opposing agonist and antagonist muscles can cause repetitive and twisting movements, or abnormal postures. Cervical dystonia (CD), often referred to as spasmodic torticollis, is a type of focal dystonia involving the muscles of the neck and sometimes the shoulders. Methods: This systematic review collates the available evidence regarding the safety and efficacy of a range of treatments for CD, focusing on their effectiveness as shown by double-blinded, randomised controlled trials. Results: Our review suggests that botulinum toxin type A (BTA), botulinum toxin type B (BTB) and trihexyphenidyl are safe and efficacious treatments for CD. Evidence shows that botulinum toxin therapies are more reliable for symptomatic relief and have fewer adverse effects than trihexyphenidyl. When comparing BTA to BTB, both are found to have similar clinical benefits, with BTA possibly having a longer duration of action and a marginally better side effect profile. BTB is also safe and probably just as efficacious a treatment in those patients who are unresponsive or have become resistant to BTA. Discussion: The current evidence shows that the pharmacological management of CD relies on BTA and BTB, two agents with established efficacy and tolerability profiles. IOS Press 2013 /pmc/articles/PMC5214602/ /pubmed/22713419 http://dx.doi.org/10.3233/BEN-2012-120270 Text en Copyright © 2013 Hindawi Publishing Corporation and the authors. http://creativecommons.org/licenses/by/3.0 This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Other Patel, Sejal Martino, Davide Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title | Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title_full | Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title_fullStr | Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title_full_unstemmed | Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title_short | Cervical Dystonia: From Pathophysiology to Pharmacotherapy |
title_sort | cervical dystonia: from pathophysiology to pharmacotherapy |
topic | Other |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214602/ https://www.ncbi.nlm.nih.gov/pubmed/22713419 http://dx.doi.org/10.3233/BEN-2012-120270 |
work_keys_str_mv | AT patelsejal cervicaldystoniafrompathophysiologytopharmacotherapy AT martinodavide cervicaldystoniafrompathophysiologytopharmacotherapy |