Dystonic Patient Responses

Dystonic Patient Responses

Darrel Templeton

8/8/2013

Thanks to everyone who took the time to respond, I really appreciate it. My
patient was admitted to the hospital shortly after our visit to detox from
prescription opiates (not disclosed in initial interview), and although she
still has attacks they are much less severe. I was able to get her into a
neutral position for casting today with minimal effort. Here are the
responses:

Yes, I have treated a similar patient. His official diagnosis was
dystonia. I did an articulated(not dorsi assist, which triggers a clonus
on him), plantar stop(adjustable), long medial forefoot trimline, soft
interface(foot), tone reducing mods(eg, DAFO....met pad, st mods, toe
crest, etc). He wore this with a work boot. This still triggered a clonus
on him, but he was really happy that he could keep his toe from dragging
and the foot stopped going into equinus. Not a pretty gait, but he stopped
falling and quit going to therapy after he got it. I would like to see a
smoother gait pattern, but his safety certainly did increase, which is the
primary goal of what we do, right? If your patient is up for it, maybe
even try dynamic forefoot wrap like a DAFO. I have had past success with
this with MS patients.

Sounds like a conversion disorder.

Hi Darrell.
Look up aspartame poisoning

I recently treated a patient who is now a transtibial amputee because of
severe dystonia as you have described in your patient. I didn't treat her
before she had the amputation, but she told me that the dystonia was so
painful that she was on multiple pain medications and could not function.
 She eventually asked to have the foot and ankle amputated, and she has
been off painkillers for 5 years. In her case, they were not able to find
any other solution to the dystonia.
I hope there is a better option for your patient, but I really wanted to
respond to your post because this was the only patient I had ever seen who
had dystonia this severe. Good luck!


Try looking at : motiontherapeutics.com

I have had one like that in my career and have tried a number of things
with the absolute best results using a standard double upright AFO with
minimal or zero free range. Probably not what you wanted to hear but works
the best. Also a female with similar onset and age parameters she actually
likes the weight of it most. Good luck

I love the list serve, thanks again everybody.

Darrel Templeton CO
Summit O&P