Dystonia Treatment Must be Highly Specialized

By Karen Hales, Neurology Solutions Contributing Writer

Dystonia is a neurological movement disorder commonly treated by Neurology Solutions Movement Disorders Center that causes involuntary repetitive twisting and sustained muscle contractions. Dystonias can be focal, affecting one part of the body, as in “writer’s cramp” or neck pulling (torticollis); segmented, impacting adjacent areas of the body; or generalized, impacting most or all of the body. A common result of these muscle spasms is a prolonged, abnormal posture due to limited control of the affected muscles.

Dozens of diseases and conditions may include dystonia as a symptom, referred to as secondary dystonias. Dystonia impacts an estimated 300,000 to 500,000 people in the United States, and approximately a third of patients are children.

Types of Dystonia

  • Generalized – Affects most or all of the body
  • Segmented – Two or more adjacent areas of the body are affected
  • Focal – The most common form, one part of the body is affected

Symptoms may be localized in a single area, such as hands, feet, or neck, and often can occur during specific actions, such as detailed movements like typing or tying shoes. They can become more severe with stress and may worsen over time.

Cervical dystonia affects the neck, causing distorted positioning of the head. Focal hand dystonia, often called “musician’s” or “writer’s cramp,” is manifested by a single muscle or small group of muscles that refuse to cooperate for prolonged periods.

Dystonia also can present itself in the eyelid, where blinking and even closing of the eyelids makes dependable sight elusive for many. It may occur in the face, jaw, or vocal cords, making speaking and eating increasingly difficult or diminishing the individual’s speech.

Depression and anxiety often are a result of a dystonia diagnosis as well as a cause for worsening symptoms.

Causes of Dystonia

Researchers believe there may be genetic or inherited factors involved in some forms of the condition. Primary dystonia is not degenerative and in some cases is caused by genetic mutations. In secondary dystonia, research has pointed to external factors and conditions that affect the transfer of stimuli from the brain to other nerves, such as brain tumors, stroke, oxygen deprivation, traumatic brain injury, or chemical changes due to medications, heavy metal exposure or carbon monoxide poisoning.

Are Dystonia and Parkinson’s Disease Related?

Dystonia and Parkinson’s disease are both movement disorders, and both conditions can occur together in certain diseases. Dystonia can be experienced as a an early symptom of PD or as a side effect of certain treatments.

Some medications might be helpful for both parkinsonism and dystonia symptoms. For example, levodopa is the most effective drug to reverse Parkinson symptoms, and it is also very effective in treating dopa-responsive dystonia (DRD) and in some patients with other forms of the condition.

Treatments for Dystonia

Dystonia treatment must be highly specialized. In most cases, the most appropriate kind of doctor to manage treatment of the condition is a neurologist with special training in movement disorders. Call Neurology Solutions at 512-865-6310 if you’d like to undergo a neurological screening.

As with many neurological disorders, modern medical research has made great strides in alleviating many damaging effects of dystonia. While there is no cure, treatments have been developed to lessen the symptoms and give patients a higher quality of life. These can include physical and speech therapy, botox injections, surgical treatments such as deep brain stimulation therapy, and several medications.

Complementary Therapies

Practicing regular stress reduction and relaxation techniques, maintaining a consistent exercise regimen and staying socially active are all important strategies for maintaining a high quality of life with the condition. Many patients report beneficial effects and symptom relief from other complementary therapies such as yoga, tai chi, massage and accupuncture, although rigorous studies evaluating the effectiveness of these therapies is lacking.

Dystonia Resources

Additional information can be found at the National Institute of Neurological Disorders and Stroke. For more, see a list and links to organizations serving patients with dystonia and other movement disorders on Neurology Solutions’ Resources Page.

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