ABSTRACT
Dystonia, a distressing movement disorder causing twitches and spasms, is often not recognised by health professionals.
Subject(s)
Dystonia , Dystonia/etiology , Dystonia/nursing , Dystonia/therapy , HumansABSTRACT
Health Related Quality of Life (HRQL) was assessed by the SF-36 in a group of patients with dystonia in New Zealand and Australia. The caregivers of these people were also asked to participate. Low scores from the SF-36 indicate a disability or limitation in HRQL. Compared with the national norms of the respective countries, the participants with dystonia for both countries were significantly lower in the eight dimensions of the SF-36, suggesting that patients with dystonia have lower HRQL compared with their respective national norms without dystonia. In contrast to the patients with dystonia, caregivers did not show lower HRQL scores than their national norms, suggesting that while dystonia affects the HRQL of those with the disorder, their caregivers may be less affected. Descriptive and demographic information were also gathered and are discussed. An important factor that may affect the HRQL of patients with dystonia is the length of time required to be diagnosed in this sample and the number of medical practitioners the patients consulted prior to a confirmed diagnosis.
Subject(s)
Caregivers , Dystonia/psychology , Quality of Life/psychology , Sickness Impact Profile , Age Factors , Aged , Australia/epidemiology , Caregivers/statistics & numerical data , Dystonia/epidemiology , Dystonia/nursing , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Sex Factors , Surveys and QuestionnairesSubject(s)
Antipsychotic Agents/adverse effects , Community Health Nursing/standards , Dyskinesias/etiology , Dyskinesias/nursing , Nursing Assessment/methods , Psychiatric Nursing , Akathisia, Drug-Induced/etiology , Akathisia, Drug-Induced/nursing , Community Mental Health Services/standards , Dyskinesia, Drug-Induced/etiology , Dyskinesia, Drug-Induced/nursing , Dystonia/chemically induced , Dystonia/nursing , Humans , Hypokinesia/chemically induced , Hypokinesia/nursing , Muscle Rigidity/chemically induced , Muscle Rigidity/nursing , Nursing Evaluation Research , Psychiatric Nursing/methods , Psychiatric Nursing/standards , Tremor/chemically induced , Tremor/nursing , United KingdomABSTRACT
Following a motor vehicle accident, Ms. G.'s head began intermittently pulling to the right. Within 6 months, the pulling worsened, leaving her head painfully fixated, touching her right shoulder. She was hospitalized for evaluation and numerous drugs were used but unsuccessfully. Baffled, her physician ordered a psychiatric consult. Hysterical conversion reaction was the resultant diagnosis. Ms. G. was treated with thioridazine and chlorpromazine, and psychotherapy was recommended.
Subject(s)
Dystonia/nursing , Accidents, Traffic , Combined Modality Therapy , Dystonia/etiology , Dystonia/therapy , Female , HumansABSTRACT
Chronic neurological illness can be difficult for patients and carers to cope with. A study was undertaken to evaluate whether the support offered by a nurse practitioner had a positive impact on coping, and to look at how such a role should develop.
Subject(s)
Dystonia/nursing , Dystonia/psychology , Nurse Practitioners , Parkinson Disease/nursing , Parkinson Disease/psychology , Adaptation, Psychological , Female , Humans , Male , Nursing Evaluation Research , Social SupportABSTRACT
The use of botulinum-A toxin will be described in two conditions--the extrapyramidal syndrome of dystonia and the pyramidal deficit, spasticity. There is no cure for dystonia and its cause is unknown. Drug therapy is unpredictable and dose-limiting side effects frequently occur with little or no alleviation of symptoms. Spasticity of adductor muscles in the lower limbs causes profound disability and major nursing problems in patients with chronic disorders of the pyramidal tract. As in the case with dystonia, drug therapy is unsatisfactory. At the UBC Movement Disorders Clinic treatment with botulinum-A has been applied to over 400 patients since 1985. The results of the first studies using this treatment in spasmodic torticollis (the most common form of focal dystonia) and spasticity (in late stage multiple sclerosis) will be discussed. As well the effects of long term treatment will be addressed. Botulinum-A toxin is approved treatment for strabismus, blepharospasm and hemifacial spasm. Approval for its use in other focal dystonias is anticipated. The very nature of the agent used for treatment requires that patients be well prepared and reassured before they undergo their first treatment. There is a wide gulf between the patients' preconceived notions about the treatment and reality.
Subject(s)
Botulinum Toxins/therapeutic use , Dystonia/drug therapy , Muscle Spasticity/drug therapy , Botulinum Toxins/pharmacology , Dystonia/nursing , Humans , Injections, Intramuscular , Muscle Spasticity/nursingABSTRACT
Dystonia refers to a specific clinical entity as well as movements occurring as a result of other syndromes. Dystonic movements are the most commonly misdiagnosed abnormal involuntary movements. Dystonia worsens under emotional or physical stress and with fatigue, lessens with rest, relaxation, hypnosis and sensory tricks, can have diurnal fluctuations and may disappear in sleep. Dystonia is often confused with chorea and myoclonus and considered to be voluntary, that is, psychogenic in origin, in part because of its unusual and varied clinical expression. The neuroscience nurse, cognizant of the natural history, phenomenology and genetics of dystonia, will be able to identify early signs and symptoms, inform colleagues and teach family members who care for children with primary dystonia.
