Treatment strategies in movement disorders.

Strategies in treatment of movement disorders are discussed with the illustration of three patients with dystonia. Pharmacotherapy can be applied in two ways: (1) a precise directed therapy, or (2) a 'shotgun' approach. Botulinum toxin is successfully injected in focal and segmental forms of movement disorders. Stereotactic neurosurgery can be considered in pharmacotherapy-resistant dystonias, but also in other forms of movement disorders. Intrathecal baclophen treatment by continuous infusion is only indicated in severe forms of spasticity.