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Team Approach and Correct Diagnosis are Key in Treatment of Dystonia

Desiree JenningsTV news magazine Inside Edition recently aired the story of Washington Redskins Cheerleader Desiree Jennings, who reportedly came down with dystonia after a flu shot. Some controversy has developed over whether she in fact has a true case of dystonia. (see Fox News interview)

Dystonia is a movement disorder caused by dysfunction (or abnormal functioning) of the brain that causes involuntarily muscle contractions in the body. This can be painful and disruptive to normal activities like walking, eating and speaking and typically worsens over time. Dr. Robert Goodman of the Center for Movement Disorders says, “Dystonia is a very unusual problem that is variable from person to person and can be difficult to diagnose. Though the outward manifestation can be the same, there are numerous causes.” He goes on to say, “A correct diagnosis is essential for determining treatment.” Dystonia can be genetic, caused by an injury, result from certain drug reactions, or be “psychogenic” (a stress response).

The first line of treatment is usually medication. Botox injections, can also be used to specifically relax the muscles that are involuntarily contracting. When these treatments aren’t enough, neurosurgeons can implant a Deep Brain Stimulator (DBS). Dr. Goodman, who specializes in this procedure, says this can be a very effective treatment for the right patient. He says the best candidates for this kind of surgery have what is called “idiopathic dystonia,” a genetic form of the disorder.

DBS implantation is done by surgeons who specialize in surgery for movement disorders such as Parkinson’s and Essential Tremor. They know that there are certain brain areas (“nuclei”) that are involved in causing the abnormal movements and place an electrode there. The electrode attaches to a small generator that is implanted in the patient’s chest. The electrode in the brain delivers electrical impulses that can modify the misfiring in the area.

Dr. Goodman emphasizes that treatment of these patients requires a team effort. “I work closely with neurologists who specialize in the specific movement disorder of the patient. These neurologists must make the correct diagnosis and play an essential role in patient care after the stimulator has been implanted.”

Though we can’t be sure of her diagnosis or what caused it, Desiree Jennings’ condition is unfortunate. How she ultimately fares, only time, and a good team of doctors will tell.

Video of Desiree Jennings on Inside Edition

For information about the flu shot check out the CDC Website

patient journey

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