In the area of dystonia treatment, we continue to provide botulinum toxin injections to our patients while training physicians to perform these injections. For patients with blepharospasm, we have been evaluating the efficacy of various types of non-invasive brain stimulation. We are also conducting therapeutic trials in blepharospasm of a cream that has an action similar to botulinum toxin. Past studies from our group have shown that certain rehabilitation techniques, such as motor training and sensory training can be therapeutic. We hav initiated a new project combining botulinum toxin and rehabilitation that might be more efficacious. New treatments are needed for essential tremor. One promising agent is 1-octanol and its metabolite, 1-octanoic acid, which we continue to develop. We have characterized the pharmacokinetics and compared the efficacy of different formulations in a dose escalation and cross-over study in patients with essential tremor. Most recently, we have completed a study with 1-octanoic acid, seeking the maximum tolerated dose. We have initiated a trial of Cognitive Behavioral Therapy for psychogenic movement disorders.

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