Autonomic dystonia

Indications Spleen/kidney vacuity cold. Chronic colitis, chronic dysentery, autonomic dystonia of the intestinal tract, intestinal tuberculosis, allergic colitis, tabes dorsalis, and pancreatic dysfunction... 

Indications Heart/kidney dual vacuity. Polyuria, spermatorrhea, nocturnal emission, turbid urine due to cystitis, loss of memory due to nervous exhaustion, chronic nephritis, diabetes mellitus, diabetes insipidus, tubular acidosis, primary aldosteronism, hyperparathyroidism, neurosis, prolapsed uterus, and autonomic dystonia... 

Injection of BoNT is currently recognized as the best available treatment for dystonias and for certain types of strabismus, and new uses are continuously found (Bhidayasiri and Truong 2005 Montecucco and Molgo 2005). In addition, BoNT/A inhibit ACh release at autonomic nerve terminals which innervate the glands and smooth muscle, and it is currently used to treat diseases such as hypersalivation and hypersudoration (Brisinda et al. 2004 Naumann and Jost 2004). 

The clinical manifestations of overdosage of trifluoperazine include CNS depression characterized by deep, unarousable sleep and possible coma, hypotension or hypertension, extrapyramidal symptoms, dystonia, abnormal involuntary muscle movements, agitation, seizures, arrhythmias, ECG changes, hypothermia or hyperthermia, and autonomic nervous system dysfunction. 

Parkinson-like effects and acute dystonias may be seen. Central nervous system (CNS) effects include somnolence and seizure activity, as well as a lack of core temperature regulation due to hypothalamic effects. Autonomic effects include dry mouth, blurred vision, and urinary retention, coupled with cardiovascular effects such as tachycardia, cardiac arrhythmias, and hypotension. 

Figure 29-1. Reiative extrapyramidai and autonomic toxicities of representative antipsychotic drugs. Ex-trapyramidai toxicities take the form of parkinsonism, akathisias, and dystonias. Autonomic toxicities are manifested as aipha-adrenoceptor blockade (orthostatic hypotension) or muscarinic blockade (dry mouth, blurred vision, urinary retention).

Uses The uses of botulinum toxin in Parkinson s disease [54" ], anal fissure [55" ], women with chronic pain [56" ], spasticity after stroke in adults [57", 58 ], and urological conditions [59 have been reviewed. The pharmacology and formulations of botuhnum toxins and data from clinical trials, demonstrating their efficacy in dystonia, spasticity, tics, tremor, dysphonia, and autonomic disorders, have been reviewed [60 ]. 

---