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Activity Dates: 04/21/2009 - 04/21/2012

This course is closed. Please look for other available products in CPNP University.

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Session Summary

Idiopathic dystonia and tremor disorders are movement disorders that are underrecognized or undertreated. Familiarity with the clinical features and available treatments will allow clinicians to better identify and manage patients with dystonia or tremor disorders. This session will utilize video cases as learning tools.

Idiopathic dystonia is a neurologic condition and can be focal, segmental, or generalized. However, focal cervical dystonia is more common in characterized by involuntary contractions of cervical musculature resulting and abnormal movements and postures of the head. It is often disabling and disfiguring. Although primarily a motor disorder, cervical dystonia is also characterized by derangements of sensory function. For example, pain can be present. Sensory tricks (gestes antagonistes) are interesting examples of abnormalities in sensorimotor integration. The majority of cervical dystonias are idiopathic and focal, i.e., there is no other associated clinical or neuroimaging features and they remain restricted to the neck and shoulder girdle muscles. There is no definitive diagnostic algorithm for dystonias nor is there universal agreement on the best approaches to management. Oral agents such as antimuscarinics provide modest benefit and are limited by side effects. Botulinum toxin provides significant relief and restores head and neck position. The role of various agents will be discussed.

Essential tremor is a common movement disorder of adulthood that interferes with the performance of functional and social activities. This type of tremor can be mistaken as Parkinson’s disease or dismissed as a benign condition. Additionally, patients with cervical dystonia may have coexisting signs of limb or head tremor which can make recognition between dystonic and essential tremor difficult.

Currently, the mainstays of pharmacotherapy consist of propranolol and primidone. However, various antiepileptic drugs can also be offered to provide symptomatic benefits. Thalamic deep brain stimulation is an alternative when medical therapy is inadequate. Effective therapies are available for focal dystonias and essential tremor. Thus, proper recognition and treatment are key for achieving optimal outcomes.

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date. (login first)
  • Complete the evaluation at the end of the activity. (login first)
  • Receive a passing grade (60%).
  • Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor. (login first)

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

Faculty Information and Disclosures

Learning Objectives

  1. Differentiate between the clinical presentation of dystonia and tremor disorders.
  2. Discuss the benefits and limitations of treatments for dystonia and tremor disorders.
  3. Outline a treatment approach for dystonia and tremor disorders

Continuing Education Credit and Disclosures

Activity Dates: 04/21/2009 - 04/21/2012
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-09-012-H01-P
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 1.0 contact hours (0.1 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program number assigned to this course is 0284-0000-09-012-H01-P (1.0 contact hours).

ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:

  1. Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
  2. Continuing medical education (CME) approved for CME hours
  3. Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration

Grant Support

This programming was supported in part by grants from Bristol-Myers Squibb, Forest Laboratories, Inc., Lilly, Schering-Plough, Cyberonics, Shire, and Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC.

Annual Meeting Grant Supporter

Recertification Education Grant Provider

Supported by an educational grant from Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC.