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Advice & Guidance Service Local Services Malnutrition & Oral Nutritional Supplements Vitamin D Deficiency Weight management
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Alcohol Misuse Opiate Dependence Non-opiate drug dependence Bristol Drug and Alcohol Service North Somerset Drug & Alcohol Service South Gloucestershire Drug & Alcohol Service Bristol Shared Care Breaking Free (Bristol & South Glos)
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DVT and SVT Pathway Pulmonary Embolus (suspected) Secondary Care DVT Services Unprovoked DVT
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Bristol Centre for Enablement Wheelchair Services
End of Life Care and Hospice
Bereavement support Death Certification and Medical Examiner End of Life Care End of life care - community support ReSPECT Plus SR1 Form (formerly DS1500) St Peters Hospice Weston Hospice
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Adrenal incidentaloma Adrenal insufficiency Advice and Guidance (Endocrinology) Endocrinology Services - UHBW and NBT Gynaecomastia Hirsutism Hyperprolactinaemia Hyperthyroidism Hyponatraemia Hypothyroidism Male hypogonadism Polyuria Primary hyperparathyroidism (PHPTH) Secondary hypertension Sub Clinical hyperthyroidism Sub Clinical hypothyroidism Thyroid Disease and pregnancy Thyroid eye disease
ENT
Advice & Guidance Service Anosmia Audiology (adult) Dizziness and Vertigo Ear wax and microsuction ENT HOT Clinic Epistaxis Hearing Problems Middle ear problems Moulded Ear Plugs Nasal Treatment Neck Lumps (including Goitre) Otitis Externa Rhinosinusitis & Nasal Polyps Snoring Speech & Language Tinnitus Tonsils Uvula
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Home > Formulary : Paediatric > Paediatric Chapters > 4. Nervous system >

BNSSG Paediatric Joint Formulary

4.3 Movement disorders

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Last edited: 04-06-2024

4.3.1 Dystonias and other involuntary movements

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

UHBW Paediatric Dystonia guideline

 

Antimuscarinics

Trihexyphenidyl (TLS Amber)

Procyclidine (TLS Amber)

Other drugs used for dystonias:

Clonidine (TLS Amber)

Gabapentin (TLS Amber)

Baclofen (TLS Amber)

Haloperidol (TLS Amber)

Midazolam (TLS Amber)

Diazepam (TLS Amber)

Chloral hydrate (TLS Amber)

Clonidine patches (TLS Red)

  • For patients with secondary dystonia and dyskinesia, according to UHBristol treatment pathway for Medical management of dystonia

 

Dopamine precursors

Co-careldopa (Sinemet®) (TLS Amber)

  • For dopamine sensitive dystonia

 

Neurotoxins (Botulinum Toxins)

Botulinum toxin type A (Botox®, Dysport®, Xeomin®)

  • NICE TA260 Botox® for use in migraine (chronic)
  • Treatment of focal spasticity as per SPC

Botulinum toxin type B (Neurobloc®) (TLS Red)

  • Botulinum toxin preparations are not directly interchangeable
  • Botulinum toxin is not approved for treatment for hyperhidrosis. For this indication exceptional funding should be sought on a case by case basis
  • To minimise the risk of errors botulinum toxin should be prescribed by brand name.
  • Botulinum toxin type B is reserved for use in patients that have become tolerant to botulinum toxin type A

 

Others

Ataluren (TLS Red)

  • NICE HST22 Ataluren for treating Duchenne muscular dystrophy with a nonsense mutation in the dystrophin gene (Specialist only)

Infliximab (TLS Red)