**Meet the editor**

Tamer Rizk, MD, FRCPCH, HMPDip (UK), is a consultant pediatric neurologist in Saint John Regional Hospital, New Brunswick, Canada. He is an assistant professor of pediatric neurology. Tamer Rizk was born in Alexandria, Egypt, and graduated from Alexandria Medical University. He has a variety of publications and research interests, including general pediatric neurol-

ogy, movement disorders, epilepsy, and cerebral palsy. Professor Rizk is author of 44 publications, including books such as: *Botulinum Toxin*-*A in Pediatric Spasticity* and *Epileptology: The Modern State of Science* published by InTech. He is a member of the British Paediatric Neurology Association, International Child Neurology Association, International Neurotoxin Association, and the Royal College of Paediatrics and Child Health; UK Consultation Panel with an interest in Community Child Health, Neurology, Neuro-Disability & Mental Health.

Contents

**Preface VII**

Tamer Rizk

**Disorders 9**

**Section 4 Tardive Dyskinesia 75**

Chana

**Section 2 Oromandibular Dystonia (OMD) 7**

Chapter 1 **Introductory Chapter: Dystonia - Different Prospects 3**

Chapter 2 **Orofacial Dystonia and Other Oromandibular Movement**

Chapter 3 **Non-Motor Symptoms in Patients with Primary Dystonia 51**

Chapter 4 **Tardive Dystonia due to D2 Antagonists and Other Agents 77**

Maria Skokou, Evangelia-Eirini Tsermpini, Adamantia Giamarelou,

**Section 3 Non-motor Syndrome of Primary Dystonia 49**

Nikolina I. Semerdjieva and Ivan G. Milanov

Athanasios Gogos and Philippos Gourzis

Nicolás Patricio Skármeta, Paula Espinoza-Mellado and Pedro

**Section 1 Introduction 1**

## Contents

**Preface XI**


Preface

minology with the new one.

specialists.

challenging to get these movements under control.

Dystonia is considered one of the most controversial diseases when it comes to diagnosis, clas‐ sification, and evidence-based lines of management. Each case is different, and it can be quite

Dystonia is a wide-spectrum disorder that affects all age groups. Management of dystonia is challenging, and specific goals should be identified. Dystonia is considered one of the most disabling conditions in the pediatric age group, which may remain until adulthood. Treatment

Current treatment aims to help decrease the frequency of abnormal involuntary movements, improve posturing, and prevent the subsequent development of contractures. Many modalities are discussed in the management part, including pharmacotherapy, oral medications, cannabis, botulinum toxin injection, and surgical interventions like intrathecal baclofen pump and deep brain stimulation for patients with generalized dystonia who failed oral pharmacotherapies. Bearing in mind the new classification, where the term "primary" is no longer recommended, and that in the majority of cases it resembles the new and more precise term "isolated", both terms are used in this chapter. To be correct when providing information from the studies cit‐ ed, it should be understood that time and effort are needed to replace completely the old ter‐

A full chapter was assigned to non-motor comorbidities encountered with dystonia, including sleep, psychiatric disorders, cognition, as well as pain and sensory symptoms, their pathophy‐ siological and biochemical mechanisms, relations with symptomatic treating strategies for ab‐

The book contains four chapters that discuss dystonia from new perspectives. The chapters have been written by different specialists from many countries. Dystonia may result from ei‐ ther diffuse or localized pathology of the cerebral cortex, brain stem, or spinal cord. Manage‐

Meige's syndrome, or "oromandibular dystonia," may be misdiagnosed as *temporomandibular joint* or psychogenic disorder, which will alter management and delay proper treatment. Dysto‐ nia with non-motor disorders includes sleep, cognitive, pain, sensory, and psychiatric disorders, and their pathophysiological and biochemical mechanisms and specific treatment are discussed. This book will be of interest to GPs, neurologists, family physicians, and internal medicine

**Professor Tamer Rizk, MD, FRCPCH, ProfDip HMPDip (UK)**

Department of Pediatrics Saint John Regional Hospital New Brunswick, Canada

normal movements, and specific treatment for non-motor signs.

ment of dystonia is challenging, and specific goals should be identified.

is usually unsatisfactory, and patients will show limited response to pharmacotherapy.
