Status dystonicus: the syndrome and its management

Brain : a Journal of Neurology
H ManjiK Bahtia

Abstract

Patients with dystonic syndromes sometimes develop increasingly frequent and relentless episodes of devastating generalized dystonia which we call status dystonicus. Twelve cases of status dystonicus, of various underlying aetiologies, are presented. Possible precipitating factors were identified in only five cases: intercurrent infection (one); discontinuation of lithium (one) and tetrabenazine (one); and the introduction of clonazepam (two). Nine patients required mechanical ventilation and three others were sedated with intravenous chlormethiazole. Drug therapy used included benzhexol, tetrabenazine, pimozide, baclofen, chlorpromazine, haloperidol, carbamazepine and acetozolamide. Two patients underwent thalamotomies, one of whom improved. Two patients died, five returned to their pre-status dystonicus condition, two eventually made a full recovery and three were worse. Patients with status dystonicus should be managed on an intensive care unit as they may develop bulbar and respiratory complications which may require ventilation. Metabolic problems encountered can include rhabdomyolysis with acute renal failure. Drug therapy with benzhexol, tetrabenazine and pimozide or haloperidol may be beneficial in some cases.

Citations

Sep 29, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·L AngeliniG Broggi
Dec 5, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·J Kalita, U K Misra
Mar 29, 2002·Movement Disorders : Official Journal of the Movement Disorder Society·Puneet OpalLaurie Ozelius
Jun 8, 2001·Movement Disorders : Official Journal of the Movement Disorder Society·M SvetelV S Kostić
Mar 1, 2002·Muscle & Nerve·Jason D WarrenPhilip D Thompson
Sep 5, 2002·Muscle & Nerve·Hans H Jung, Sebastian Brandner
Nov 19, 2008·Journal of Neurology·Kathleen L Poston, Steven J Frucht
Apr 19, 2011·Journal of Neurology·Chul Hyoung Lyoo, Myung Sik Lee
Jul 1, 2005·Current Neurology and Neuroscience Reports·Steven J Frucht
Feb 15, 2007·Current Treatment Options in Neurology·Shu-Ching Hu, Steven J Frucht
Nov 5, 2010·Indian Pediatrics·Devendra MishraMonica Juneja
Mar 15, 2006·The Neurologist·Roongroj Bhidayasiri
Dec 17, 2004·Clinical Neuropharmacology·D PaleacuS Badarny
Jan 27, 2010·Journal of Orthopaedic Trauma·Michael A FlierlPhilip F Stahel
Feb 18, 2011·Current Opinion in Critical Care·Jonathan Rhodes
Jan 1, 2004·Neuromodulation : Journal of the International Neuromodulation Society·John YianniTipu Aziz
Jan 1, 2009·Neuromodulation : Journal of the International Neuromodulation Society·Hans-Holger Capelle, Joachim K Krauss
Apr 27, 2007·Archives of Disease in Childhood·Jeremy R ParrTipu Z Aziz
Aug 23, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·Robin S HowardNicholas P Hirsch
Sep 25, 2002·Canadian Journal of Physiology and Pharmacology·Mahmoud M El-MasFouad M Sharabi
Jul 12, 2012·Therapeutic Advances in Neurological Disorders·Cathérine C S Delnooz, Bart P C van de Warrenburg
Sep 3, 2010·Journal of Medical Case Reports·William MuirheadMichael Vloeberghs
Jan 3, 2012·Journal of Neurosurgery. Pediatrics·Brian P WalcottEmad N Eskandar
Sep 17, 2013·Journal of Neurosurgery. Pediatrics·Yasushi Miyagi, Yu Koike
Dec 21, 2013·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Steven J Frucht
Dec 3, 2013·Journal of Neural Transmission·Angelo FranziniDario Caldiroli
Jul 27, 2002·Brain & Development·Gülhis DedaUlker Doğru
Apr 21, 2004·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Joachim K KraussTipu Z Aziz
Feb 10, 2006·Expert Review of Neurotherapeutics·Christopher Kenney, Joseph Jankovic
Jun 21, 2006·Expert Review of Neurotherapeutics·Roongroj Bhidayasiri, Daniel Tarsy
Mar 19, 2014·Neurologia i neurochirurgia polska·Michał Roman SobstylMirosław Ząbek
May 1, 2013·Progress in Neurobiology·Christiane WoopenLars Timmermann
Jan 17, 2012·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Salvatore GrossoPaolo Balestri
Jan 20, 2012·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Hortensia GimenoJean-Pierre Lin
Apr 7, 2010·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·A RoubertieD Doummar
Jan 30, 2010·Parkinsonism & Related Disorders·Tipu Z Aziz, Alexander L Green
Nov 10, 2009·Parkinsonism & Related Disorders·Takashi MorishitaMichael S Okun
Dec 8, 2004·Movement Disorders : Official Journal of the Movement Disorder Society·Christopher M KippsJohn G L Morris
May 17, 2005·Movement Disorders : Official Journal of the Movement Disorder Society·Giovanna ZorziGiovanni Broggi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Related Papers

Arquivos de neuro-psiquiatria
Hélio A G TeiveLineu César Werneck
Movement Disorders : Official Journal of the Movement Disorder Society
Paolo MariottiAnna Rita Bentivoglio
Neurology
Joseph Jankovic, A S Penn
Indian Pediatrics
Devendra MishraMonica Juneja
© 2022 Meta ULC. All rights reserved