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Does this sound familiar? A medical student is asked how to treat a particular neurological disorder and gives a one-word answer: the name of a single drug. Frustratingly, treatment is rarely that simple—even for conditions like dopa-responsive dystonia (the diagnosis of which is reviewed see page 340), where the clue in the name that suggests that this should be straightforward. The medical student's single word answer usually prompts a discussion about different types of treatment beyond the ‘headline’ drug or other intervention. This leads to a recognition that, in addition to disease specific treatments (if they exist), there are treatments to help to control symptoms and also a range of supportive strategies that are not disease-specific.
For many patients with neurological disease, the disease-specific treatments are limited and symptom management is the key. Some symptoms respond to …
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