Recommended first-line treatment options for managing dystonia in adults:
Adults with problematic dystonia should be referred to a tone or spasticity management service to consider treatment options.
Enteral anti-dystonic drug treatments are used, but levodopa is not recommended except as a therapeutic trial to identify dopa-responsive dystonia.
Drugs should not be rapidly withdrawn if used for more than 2 months or at high doses; dosage reduction should be gradual to avoid withdrawal symptoms.
There is no specific first-line oral drug explicitly recommended for dystonia in adults with cerebral palsy in the provided guidelines, but referral to specialist services for tailored management is emphasized.
Botulinum toxin type A may be considered for focal dystonia affecting function, pain, or participation, but this is generally after specialist assessment.