What are Dystonias?
Dystonia is a condition characterized by involuntary muscle contractions that cause repetitive or twisting movements of an affected body part. Contractions can affect one muscle, groups of muscles, or muscles throughout the body. These uncontrollable movements are often accompanied by pain and can interfere with the ability to perform day-to-day tasks.
Dystonia can be classified by the parts of the body affected:
- Focal dystonia is localized to a specific part of the body (for example, the left arm).
- Segmentalized dystonia affects two or more adjacent parts of the body (for example, the left arm and left hand).
- Multifocal dystonia involves two or more unrelated body parts.
- Hemidystonia involves the arm and the leg on the same side of the body.
- Generalized dystonia affects most or all of the body.
Forms of focal dystonia include:
- Cervical dystonia affects the muscles in the neck that control the position of the head, causing the head to turn to one side or be pulled forward or backward.
- Blepharospasm affects muscles in the eyes, causing rapid blinking or spasms that force the eyelids to close completely.
- Craniofacial dystonia affects the muscles of the head, face, and neck.
- Task-specific dystonia occurs during a particular repetitive activity, such as handwriting or playing an instrument.
Involuntary muscle contractions are the primary symptom of dystonia. They can cause your body to assume twisting, repetitive, or painful postures. Symptoms may be progressive, and they may be aggravated by stress, anxiety, or fatigue.
Depending on the form of dystonia, symptoms may include:
- Foot cramps
- Tendency of one foot to turn or drag
- Rapid blinking
- Involuntary spasms that cause your eyelids to close
- Uncontrollable head movements
- Difficulties opening and closing your mouth
- Difficulty swallowing
- Strained, breathy, or slurred speech
- Cramps while doing a particular activity, such as handwriting or playing an instrument
Symptoms of dystonia vary depending on which muscles are affected and can signal a serious underlying condition. Contact a medical professional if you believe you are experiencing involuntary muscle contractions.
Treatments for dystonia are aimed at decreasing spasms, pain, and disturbed postures.
Botulinum Toxin (Botox, Dysport, Myobloc, Xeomin) for Dystonia
Chemical denervation using Botox is a common treatment for dystonia. It temporarily and partially paralyzes the muscles involved and is most effective when used for focal dystonia.
Deep Brain Stimulation (DBS) for Dystonia
Deep brain stimulation (DBS) describes a treatment in which a neurosurgeon implants a device called a neurostimulator in your brain to deliver a small electrical stimulus to your basal ganglia. Once the device is turned on, your symptoms may diminish.
It usually takes several months for your doctor to program your stimulator to give you the most relief.
How common is dystonia?
As many as 300,000 Americans are living with dystonia.
Who gets dystonia?
Dystonia can occur at any age, but it is often described as early, or childhood, onset.
Some forms of dystonia are genetic, but the cause of most cases is unknown. The disease may be linked to dysfunctional communication between nerve cells in the basal ganglia, a region at the base of the brain where muscle contraction commands originate.
Dystonia is sometimes a symptom of another disorder or condition, including:
- Parkinson’s disease
- Huntington’s disease
- Wilson’s disease
- Traumatic brain injury
- Birth injury
- Brain tumor
- Paraneoplastic syndromes
- Oxygen deprivation
- Infections, such as TB or encephalitis
- Reactions to certain medications
- Heavy metal or carbon monoxide poisoning
How is dystonia diagnosed?
There is no single test that can definitively diagnose dystonia. Your doctor will review your symptoms and medical history during a physical examination and may order any of the following tests:
- Blood tests
- Urine tests
- CT scan
- MRI scan
- Electromyography (EMG)