Cedars-Sinai experts to present free conference on dystonia for patients, families and caregivers

Michele Tagliati, MD, director of the Movement Disorders Program, will open the program with an overview of symptoms, causes and ways to manage dystonia. Tagliati is an expert in all facets of dystonia treatment, including drug therapy, botulinum neurotoxin injection and deep brain stimulation. He also specializes in the treatment of the involuntary muscle contractions of tremor, chorea, tics and Parkinson's disease.

Medications often are the first line of treatment for dystonia, but if drugs fail - as often happens - or side effects are excessive, patients may benefit from injections of botulinum neurotoxin, commonly known by the trade names BOTOX, Myobloc and Dysport. Before botulinum neurotoxin injections became known for the cosmetic purpose of relaxing wrinkles, they were found to temporarily interrupt faulty nerve pathways involved in movement disorders.

Deep brain stimulation, approved in 2003 for use in patients with dystonia, is a third option. Electrical leads are implanted deep in the brain, and a pulse generator is placed near the collarbone. The device later is programmed with a remote, hand-held controller. Tagliati directs a course in device programming every year at the annual meeting of the American Academy of Neurology.

At the Oct. 11 conference, sessions on botulinum neurotoxin treatment for dystonia affecting the neck, face and limbs will be presented by Tagliati; Steven Graff-Radford, DDS, director of the Program for Headache and Orofacial Pain at the Cedars-Sinai Pain Center; and Ryan Kotton, MD, director of the High Risk Infant Progress Clinic and Pediatric Rehabilitation in the Department of Physical Medicine and Rehabilitation.

Adam Mamelak, MD, professor of neurosurgery, director of the Functional Neurosurgery Program in the Department of Neurosurgery and co-director of the Pituitary Center, will make a presentation on deep brain stimulation. Achieving optimal results with DBS depends on precise adjustment of electrical stimulation - the fine-tuning process that is Tagliati's specialty - and pinpoint-perfect placement of electrodes - one of Mamelak's areas of expertise. He performed deep brain surgical procedures before DBS was approved for Parkinson's disease in 2002 and for dystonia a year later.