Dystonia

What is Dystonia?

Dystonia is a condition that is identified by contractions of the involuntary muscles which cause movements of a repetitive nature. A person might sense painful movements and experience tremors. There are various types of dystonia that are genetic in nature. Dystonia is thought to be a neurological condition, caused by problems of the nervous system. However, in most cases, brain functions such as intelligence, memory, and language remain unaffected. Primary dystonia is mainly hereditary and its generalized form is the most difficult to live with and treat. Dystonia is not associated with problems in thinking or understanding, but depression and anxiety may be present.

There are five types of dystonia:

Focal dystonia - affecting muscles around the eyes, in the neck, in the throat, or in one of the limbs.

Segmental dystonia - affecting an area of the body, such as the neck and an arm.

Hemidystonia - affecting the arm and leg on one side of the body.

Multifocal dystonia - affecting two or more parts of the body that aren’t connected, such as the left arm and leg.

Generalised dystonia – affecting both legs and other regions of the body.

Symptoms

Symptoms of this disease vary with its form. Some of the symptoms include:

Disposition to turn or drag one foot after running or walking some distance.
Involuntary turning of the neck when a person is stressed or extremely tired.
Rapid blinking or closing of eyes due to spasms.
Difficulties in speech.
Depression and anxiety.

Causes

The exact cause of dystonia is not known. While, there are certain types of dystonia that are inherited, or acquired. Dystonia is basically caused due to damage to the basal ganglia, the area of brain that initiates muscle contraction. The damage may be caused due to:

Stroke.
Deprivation of oxygen.
Poisoning due to carbon monoxide or lead.
Infections like tuberculosis.
Reactions due to certain medications.
Brain tumour.
Parkinson’s disease.
Wilson’s disease.
Huntington’s disease.

Risks

Major risk factors are:

Family history.
Women are more likely to develop cervical dystonia.
The probability of the disorder arises after the age of 30.
History of postural tremor.

Prevention

Primary dystonia is not preventable as it is inherited. However secondary forms can be prevented by:

Adopting healthy lifestyle.
Regular exercising and muscle stretching.

How is it diagnosed?

Dystonia is diagnosed by a neurologist, who will examine the patient’s history, and conduct a complete physical and neurological examination. At Medanta, our neurologists may carry out various di...

Blood tests
Urine tests
CT scan
MRI scan
X-ray
Genetic tests

How is it treated?

Treatment of dystonia is based on individual and specific needs. At Medanta, our neurologists may employ different methods to treat the disease:

Anticholinergics

It is a type of medication used for the treatment of dystonia. It functions by obstructing the release of acetycholine, a neurotransmitter known to cause muscle spasms. It might have side-effects such as dry mouth, confusion, and blurred vision, but do not adversely affect health.
Baclofen

It is used to treat extreme tension in the muscle, caused by a stroke. It is best for treating people with generalised dystonia.
Muscle relaxants

Muscle relaxants function by upgrading the levels of a neurotransmitter, known as gamma-aminobutyric acid (GABA) that help relax affected muscles. Effective muscle relaxants used to treat dystonia are diazepam, clonazepam, and lorazepam.
Physiotherapy

Physiotherapy helps maintain motion, posture improvement, and the prevention of shortening of affected muscles.
Deep brain stimulation (DBS)

It is a brain surgery wherein the surgeon runs electrodes through each of the two holes in the skull, and places them in a part of the basal ganglia, also known as globus pallidus. This is also effective in treating dystonia.

When do I contact the doctor?

You should consult a doctor if you frequently observe symptoms like depression, anxiety, involuntary turning of the neck, or proneness to drag the foot. The doctor will carry out various physical examinations and tests to identify dystonia and its type. Thereafter, he will carry out the required treatment.

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