Advanced treatments in dystonia

ADVANCED TREATMENTS IN DYSTONIA Marie VIDAILHET, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital Salpetriere, Paris, France Therapeutic strategy for dystonia can be approached in two ways: based on etiology and pathophysiology, which concerns a small number of diseases and syndromes among which some paroxysmal dystonias/abnormal movements (Glut 1 deficiency), rare genetic forms (ADCY5, L-Dopa sensitive dystonia) or diseases in which dystonia is one of the multiple clinical expressions (Wilson) or based on phenomenology and dystonia severity. In most cases, the treatment is mainly symptomatic and based on a single or combined approach with botulinum toxin-kinesitherapy/medications/deep brain stimulation. Although a long experience is being acquired with long term follow-up results. Therapeutic advances are being made as a result of new pathophysiological, imaging or physiological data, technological developments (DBS, FUS) or a better definition of the objectives and a more complete evaluation of the results, taking into account not only the motor signs but also the non-motor signs. Moreover, teams experience has expanded over the year, from pediatric forms to the long-term effects of parties who combine very long follow-up periods, with the consideration of age and long-term effects of treatments. These different elements will be discussed with clinical cases and take home messages.