What Is Dystonia?

Dystonia is a movement disease characterized by uncontrollable muscle contractions. The injured body part twists automatically as a result of the contraction, resulting in repetitive movements or unusual postures. Dystonia can strike a single muscle, a group of muscles, or the entire body. Dystonia affects roughly 1% of the population, and it is more common in women than in men.

Different types of dystonia have an impact on various sections of the body. Some only appear when one performs a specific action such as typing. Symptoms may worsen with prolonged activity, weariness, or stress. They may get more severe over time in some circumstances.

Some cases are hereditary, and others are caused by external sources such as brain injury, exposure to chemicals, or the use of certain medications. In many situations, the cause is unclear.

Dystonia has no known cure, however, medication, surgery, and physical therapy may assist to alleviate symptoms.

Symptoms of Dystonia

Dystonia symptoms range from moderate to severe, and depending on the type, can affect different regions of the body. Some varieties have an impact on posture. There may be a tremor or other neurological symptoms, and the symptoms might be uncomfortable. The type of dystonia will determine the specific early symptoms. Here are a few common examples:

• cramps in the feet
• a “dragging leg”
• a deterioration of handwriting that occurs after a few lines of writing.
• actions such as twisting or shaking
• repetitive movement such as uncontrollable blinking
• speaking difficulties
• involuntary pulling

Types of Dystonia

Cervical Dystonia

The most frequent type of focal dystonia is cervical dystonia, often known as torticollis. It usually starts in adults between the ages of 30 and 50, though it can start earlier. Women are more likely to suffer from cervical dystonia. Symptoms of cervical dystonia include:

• the chin twisted toward the shoulder (torticollis)
• tremor in the hands
• tipping the head forward, backward, or sideways
• tilting the head forward or backward on the shoulders

Symptoms can be triggered by certain postures or situations, and they can be aggravated by stress or excitement. Putting your hand on your cheek or the back of your head can help reduce symptoms.

Cervical spine arthritis, nerve root compression, and constriction of the spinal cord in the neck are all possible complications. Some persons may experience severe discomfort. Although remission is possible, it is usually just temporary.

Dopa-Responsive Dystonia

Dopa-responsive dystonia is more common in children. Its name comes from the fact that it reacts well to levodopa, a drug that increases dopamine production in the brain.

Starting around the age of six, a person may develop the following symptoms:

• inward or upward turning feet
• leg tremors, muscular contractions, and uncontrolled movement
• By adolescence, symptoms had spread to the arms and ultimately the entire body.
• limb position that is unusual
• when walking or running, there is a loss of coordination

Complications can include:

• issues with sleep
• depression
• parkinsonism; a movement disorder that causes a variety of issues.

Symptoms might range from mild to severe, although they normally settle down around the age of 30

Upper Limb Dystonia

Writer’s cramp, occupational cramp, or graphospasm is a common upper limb dystonia. Repetitive activities like writing and attempting to play the piano or other musical instruments can trigger task-specific dystonia, which manifests as hyperextension or hyperflexion of the wrist and fingers. The spasm goes away once the task is completed.

Blepharospasm

Blepharospasm is a rare condition in which your eyelids twitch or blink. You have no control over it. Involuntary blinking or twitching is the term for this. A muscular spasm around your eye causes the twitching. Symptoms include:

• eyelid twitching
• involuntary blinking
• other facial movements

It may happen only occasionally at first, but some people acquire a severe, long-term twitch.

Sometimes, twitching can occur without warning and for no obvious reason. It can also occur with:

• Parkinson’s disease
• dry eyes
• caffeine overdose
• sleep deprivation

Generalized Dystonia

Generalized dystonia usually begins in infancy or adolescence. It affects muscle groups in various regions of the body. Typically, it begins in the trunk or limbs. Symptoms include:

• A twisted or rotated foot, which is generally the first indicator
• Trouble controlling or coordinating bodily motions.
• Muscle spasms in the trunk or limbs that may or may not be uncomfortable
• Quick, rhythmic, or jerky motions
• Certain portions of the body may remain in an unusual position

Classifications of Dystonia

Dystonic contractions can have a chronic course, leading to severe persistent pain and incapacity, regardless of the source. The differentiation between the various forms of dystonia is clinically important since each form is treated differently.

The following characteristics can be used to classify dystonia:

• by clinical features, such as age, onset, and which parts of the body they affect by body part and if it affects one or more areas
• by time, depending on whether it gets worse or stays the same with activity or at different times of day
• By etiology, which examines underlying neurological damage, hereditary and environmental factors, or if no clear cause can be found

What Causes Dystonia?

Dystonia can be caused by a variety of reasons, including genetics and the environment. Genetic alterations are sometimes inherited and might be present from birth. Different genetic variables can alter the chemical balance in ways that cause dystonia to manifest in various forms.

Dystonia can be triggered by a variety of environmental and medical reasons, some of which are:

• stroke
• brain tumor
• inadequate oxygen to the brain
• exposure to heavy metals or carbon monoxide
• use of drugs such as antipsychotics, dopamine agonists, and others
• a severe brain injury or spine injury

Some types of dystonia appear to be caused by abnormalities with the basal ganglia, a region of the brain that controls involuntary movements. Some researchers, however, believe that this does not account for all types of dystonia and that other brain regions may be implicated.

How to Treat Dystonia

Dystonia does not have a cure, so treatment focuses on alleviating symptoms. Treatments range from medications, therapy, surgery (deep brain stimulation and selective denervation surgery) depending on the type and symptoms that accompany it.

Here are some medications used for dystonia:

• Botulinum toxin (Botox) injections prevent the release of acetylcholine, a neurotransmitter that causes muscles to contract
• Dopaminergic agents help increase or decrease the amount of dopamine in the brain, which is a neurotransmitter involved in the movement
• Anticholinergics prevent acetylcholine from being released
• Muscle relaxants like diazepam (Valium) control the neurotransmitter GABA, yet they can make you sleepy

Therapy, too, is an option:

• Physical treatment, occupational therapy, or a combination of both may be used to alleviate symptoms and enhance function
• If your voice is affected by dystonia, you may benefit from speech therapy
• You can relieve muscle pain by stretching or massage

Surgery comes into play when the aforementioned treatments don’t work and if symptoms are severe. There are two kinds which include:

Deep Brain Stimulation (DBS)

A type of brain stimulation where electrodes are surgically placed in a specific area of the brain and linked to a generator in the chest. The generator provides electrical pulses to your brain, which may aid with muscular contraction control. The generator’s settings can be changed to cure your problem.

Selective Denervation Surgery

This operation, which involves severing the nerves that control muscle spasms, may be an option for treating dystonia that hasn’t responded properly to conventional treatments.

Now that you Know…

Dystonia is a movement disorder, and there are varieties of them, which affect people of all ages and in a variety of ways. Symptoms might be moderate to severe, depending on the type. Dystonia does not have a cure at the moment, although drugs can help. There are also physical therapy, surgery, and deep brain stimulation as alternatives.