Short communication| Volume 75, P242-244, May 2020

Download started.


Patient-reported responses to medical treatment in primary dystonia

Published:April 02, 2020DOI:


      • Benzodiazepines are useful pharmacological options in primary dystonia.
      • Levodopa may be considered in the management of isolated limb dystonia.
      • Management of dystonia should take into account the individual treatment responses.


      In the absence of pathogenesis-targeted therapy in most types of primary dystonia, the current management strategy is largely symptomatic. Our aim was to comparatively evaluate the patients’ perception of symptomatic benefits with the medical treatment of primary dystonia. We reviewed the medical records of 206 patients who received medical treatment upon diagnosis of primary dystonia. The patients were prescribed five different dystonia medications: clonazepam, trihexyphenidyl, nortriptyline, baclofen, and levodopa. Patients tried one type of medicine during each following week and whether each medication was beneficial was recorded in a binary fashion. Subgroups analysis was performed according to the body distribution, duration, ages at onset and treatment of dystonia. A total of 172 patients were included in the analysis. The majority (84%) had focal dystonia, most frequently cervical dystonia and blepharospasm. Clonazepam received the most favorable response (40%), followed by baclofen (20%) and trihexyphenidyl (20%). Patients with focal limb dystonia gave higher rate of positive responses to levodopa (24%) compared to other focal dystonia subgroups. Clonazepam, followed by baclofen and trihexyphenidyl is a useful pharmacologic option for primary dystonia. Levodopa can be considered for isolated limb dystonia.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Jankovic J.
        Treatment of dystonia.
        Lancet Neurol. 2006; 5: 864-872
        • Jinnah H.A.
        • Factor S.A.
        Diagnosis and treatment of dystonia.
        Neurol Clin. 2015; 33: 77-100
        • Jankovic J.
        • Ford J.
        Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients.
        Ann Neurol. 1983; 13: 402-411
        • Greene P.
        • Shale H.
        • Fahn S.
        Analysis of open-label trials in torsion dystonia using high dosages of anticholinergics and other drugs.
        Mov Disord. 1988; 3: 46-60