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Twists and Turns 

Twists and Turns
Chapter:
Twists and Turns
Author(s):

Susan H. Fox

DOI:
10.1093/med/9780190607555.003.0020
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date: 12 April 2021

Focal dystonia is the most common clinical manifestation of primary dystonia. The focal and sometimes task-specific nature of the symptoms makes daily drug therapy less attractive due to a requirement for exposure to high doses of anticholinergic agents that are typically only minimally effective. Botulinum toxin therapy can be targeted to a specific muscle group that is judged to be most active, providing relief for 3 months although not necessarily modifying the underlying disease pathophysiology, which remains uncertain. Deep-brain stimulation is currently reserved for the most resistant cases in which the disability or pain derived from the dystonia justifies consideration of neurosurgery.

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