Current and emerging strategies for treatment of childhood dystonia

Abstract

Childhood dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contractions causing twisting and repetitive movements, abnormal postures, or both (Sanger et al, 2003). Dystonia is a devastating neurological condition that prevents the acquisition of normal motor skills during critical periods of development in children. Moreover, it is particularly debilitating in children when dystonia affects the upper extremities such that learning and consolidation of common daily motor actions are impeded. Thus, the treatment and rehabilitation of dystonia is a challenge that continuously requires exploration of novel interventions. This review will initially describe the underlying neurophysiological mechanisms of the motor impairments found in childhood dystonia followed by the clinical measurement tools that are available to document the presence and severity of symptoms. Finally, we will discuss the state-of-the-art of therapeutic options for childhood dystonia, with particular emphasis on emergent and innovative strategies.

Keywords: Childhood; Dystonia; Movement disorders; Physical therapy; Rehabilitation.

Figure 1

EMG-based biofeedback device with vibration motor embedded. The device alerts the person of his/her muscle activity with smooth changes in the speed of a silent vibration motor. Proportional tactile feedback is achieved by driving the motor with a signal proportional to the estimated EMG power, and the vibration is provided at the site of the active muscle.