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Dystonia

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What is Dystonia?

Dystonia is a neurological movement disorder that causes abnormal muscle contractions leading to twisted postures or movements, tremors and muscular pain. It can affect different body parts, such as the neck, eyes, or limbs.

There are different ways to classify dystonia based on the body part affected, the cause, or the age of onset. Some common types of dystonia are:

  • Focal dystonia – affects a single body part, such as the neck (cervical dystonia or spasmodic torticollis), eyelids (blepharospasm), jaw (oromandibular dystonia), or hand (Writer’s cramp).
  • Segmental dystonia – affects two or more adjacent body parts, such as the face and neck.
  • Multifocal Dystonia – affects two or more non-adjacent body parts.
  • Generalized dystonia – affects most or all of the body.
  • Hemidystonia – affects one side of the body.

What Are the Symptoms of Dystonia?

The symptoms of dystonia can vary depending on the type and location of dystonia. Some common symptoms are:

  • Spasmodic dysphonia – a voice disorder that causes strained, hoarse, or breathy speech
  • Stridor – a high-pitched sound when breathing caused by narrowing of the airway
  • Dystonic cough – a chronic cough that is triggered by vocal cord spasms.
  • Discoordinated breathing – a condition where the breathing muscles are not synchronized with the vocal cords.
  • Paroxysmal hiccups or sneezing – sudden and uncontrollable episodes of hiccups or sneezing caused by diaphragm or nasal spasms.
  • Non-motor symptoms, such as pain, depression, anxiety, sleep problems, cognitive impairment, and sensory disturbances that can affect people with dystonia.

The causes of dystonia are not fully understood, but they may involve genetic mutations, environmental factors, brain abnormalities or other diseases.

Dystonia can also be a symptom of other conditions, such as Parkinson’s disease, Huntington’s disease, Wilson’s disease, stroke or traumatic brain injury.

Some of the risk factors for dystonia include:

  • Having a family history of dystonia
  • Women are more likely to develop dystonia than men
  • Being exposed to certain toxins, such as heavy metals or carbon monoxide
  • Having a brain injury or infection
  • Emotional stress can trigger or worsen dystonia symptoms
  • Taking certain medications, such as antipsychotics or antidepressants
  • Certain repetitive tasks, such as writing in Writer’s cramps

Dystonia is diagnosed based on a clinical assessment that involves a careful history and physical examination of the patient. The examiner needs to identify the characteristic features of dystonia.

Your movement disorder neurologist will also use various tests and tools, such as:

  • Genetic testing
  • Neuroimaging (MRI, PET, or SPECT)
  • Electrophysiology (EMG, EEG, etc.)

Treatment Options for Dystonia

The choice of treatment depends on various factors, such as patient preference, availability, cost, side effects, and efficacy. The treatment may need to be adjusted over time as dystonia can change or progress.

  • Oral medications that act on various neurotransmitters or receptors in the brain, such as anticholinergics, dopamine agonists or antagonists, and benzodiazepines are commonly used.
  • Botulinum toxin injection blocks the release of acetylcholine at the neuromuscular junction and causes temporary muscle paralysis. This can help relieve pain and improve function.
  • Deep Brain Stimulation (DBS) can be used for various types of dystonia, such as cervical, segmental, or generalized dystonia.

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Melbourne Neurocare is here to help you overcome your dystonia. Our skilled neurologists can provide you with the best care and guidance for different types of dystonia and movement disorder conditions.
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