Status Dystonicus [Neurosurgery Wiki]

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====== Status Dystonicus ======
Status Dystonicus is a severe form of [[dystonia]], a [[movement disorder]] characterized by involuntary muscle contractions that cause twisting, repetitive movements, and abnormal postures. It is a medical emergency that can be life-threatening if not promptly treated.

In Status Dystonicus, the dystonic symptoms are sustained and do not respond to the usual treatment methods, such as oral medications or botulinum toxin injections. The symptoms can involve the face, neck, limbs, and trunk, and can cause difficulties with breathing, speaking, and swallowing.

The causes of Status Dystonicus can include medication changes, medication withdrawal, or underlying neurological conditions such as Parkinson's disease or dystonia-plus syndromes.

The treatment of Status Dystonicus typically involves hospitalization and intensive care. Medications such as benzodiazepines, muscle relaxants, and anticholinergics may be used to help control the symptoms. In some cases, deep brain stimulation or intrathecal baclofen therapy may be considered as a long-term treatment option.

Prompt recognition and management of Status Dystonicus is crucial to prevent complications and improve outcomes.

===== Treatment =====

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1roWqUHnCMOr0L0hCUJqCTxMozDZCslAGXXAWF-e04shJnb5DC/?limit=15&utm_campaign=pubmed-2&fc=20230313035322}}

It is considered a medical emergency and requires immediate treatment.

The treatment of status dystonicus may involve a combination of medications, supportive care, and sometimes surgery. The goals of treatment are to stop the muscle spasms, control pain, prevent complications, and restore normal functioning.

Some medications commonly used to treat status dystonicus include:

Benzodiazepines: These drugs can help to relax the muscles and reduce anxiety.

Muscle relaxants: These drugs work by blocking the signals that cause the muscles to contract.

Anticholinergics: These drugs can help to reduce excessive sweating, drooling, and tremors.

Intravenous (IV) fluids and electrolytes: These can help to correct any imbalances in the body caused by the muscle spasms.

Botulinum toxin injections: These injections can help to reduce muscle spasms and improve function in affected areas.

Deep brain stimulation (DBS): This surgical procedure involves implanting a device in the brain that can help to regulate movement.

Sedation and intubation: In severe cases, patients may need to be sedated and intubated to prevent complications related to muscle spasms and breathing difficulties.

The specific treatment approach will depend on the individual patient's symptoms, medical history, and overall health. It is important to seek medical attention immediately if you or someone you know is experiencing symptoms of status dystonicus.

Guil-Ibáñez JJ, Márquez-Rivas J. Status Dystonicus: Emergent Treatment With Intrathecal Baclofen Pump. Neuromodulation. 2023 Mar 11:S1094-7159(23)00100-9. doi: 10.1016/j.neurom.2023.02.073. Epub ahead of print. PMID: 36907713
((Guil-Ibáñez JJ, Márquez-Rivas J. Status Dystonicus: Emergent Treatment With Intrathecal Baclofen Pump. Neuromodulation. 2023 Mar 11:S1094-7159(23)00100-9. doi: 10.1016/j.neurom.2023.02.073. Epub ahead of print. PMID: 36907713.))