[Sandel]

Clinical improvement of secondary focal limb dystonia in neurodegenerative disease following a five-day lidocaine infusion:

A case report.
Irwin D, Revuelta G, Lippa CF.
Drexel University College of Medicine, Department of Neurology, Philadelphia, PA, USA.

Dystonia associated with neurodegenerative disease has minimal effective treatment options and can be devastating to a patient's ability to perform tasks of daily living. We present a case of a 55 year-old man who had progressive symptoms of an atypical asymmetric parkinsonian neurodegenerative disease. This patient presented with a dystonic left upper extremity that was refractory to treatment. In an attempt to treat worsening pain associated with the dystonia, he was given a five-day lidocaine infusion for associated pain and within 24 h had improvement in mobility of his dystonic extremity. Dystonia was measured by the Burke-Fahn-Marsden (BFM) dystonia rating and disability scales on hospital day five and at an eight week follow up visit. These scores were compared with scores derived from his previous pre-treatment neurologic examination. The BFM dystonia scale score was initially 16 and improved to 12 on both immediate post-treatment and eight-week follow-up. The BFM disability score improved from 16 to 6 post treatment and to 8 on follow-up appointment. Most importantly, the patient could feed and dress himself for the first time in several years. No adverse events of treatment were encountered. Treatment effect lasted three months with a slow return to baseline motor function. This case report raises interesting questions regarding the mechanism of dystonia in neurodegenerative disease and suggests the afferent sensory system as a potential target for therapeutics.

http://www.docguide.com/news/content..._uids=18958315

[ali12]

Thank you so much for posting this Sandel!! I found it really interesting as I have Dystonia in both of my RSD limbs (left leg and right arm) and I haven't found anything that helps with it yet. I have been on sooo many muscle relaxants it's unreal and my Physical Therapist's are now wanting to put my leg in a cast up to my hip - this is something which I certainly don't want doing as I know casting an RSD limb is dangerous!! I have had my leg casted before and it made the Dystonia and muscle spasms worse.

I've also had a doctor tell me and my mum that the best option I have left now is to have pins put through my bones and my muscles to try and calm the muscles down and stop them from spasming too much. Not really sure if that would help and don't know if he knows anything about Dystonia as he was an Orthotics Doctor and I usually see Neurologist's for the Dystonia.

It has also been suggested for me to try Botox by my PT's in London however my PM Doctor has said he wouldn't suggest it. I have had a nerve block into my RSD leg and it made me so much worse and so did removing an ingrown toenail so my doctor feels that all of the injections needed for the Botox would "wind my leg up" even more.

Thank you again for posting this ... i'm going to show it to my PT's and see what they say.

[Sandel]

I realy hope it can help Ali.
hugs hon