Description

Dystonia is a movement disorder that causes muscles to contract. This can cause twisting movements or other movements that occur repeatedly and are not under the control of a person.

When the disease affects a part of the body, is called focal dystonia. When it affects two or more areas of the body, next to each other, it is called dystonia, segmental. When dystonia affects all parts of the body, by what is known as the general of the dystonia. The muscle spasms can range from mild to more severe. They can be painful, and can affect a person's ability to complete daily tasks.

There is No cure for dystonia, but medications and therapy can improve the symptoms. Surgery is sometimes used to disable or regulate the nerves or in certain regions of the brain in people with severe dystonia.

Symptoms

Dystonia affects different people in different ways. Muscle spasms can:

  • Begin in a single area, such as legs, neck, or arm. Focal dystonia that begins after 21 years of age usually begins in the neck, arm, or face. Although it tends to stay in the same area, may spread to a neighboring area of the body.
  • Occur during a specific action, such as writing by hand.
  • Made worse by stress, fatigue or anxiety.
  • Become more visible over time.

The areas of the body that may be affected are:

  • Neck. When the muscles of the neck are involved, it is called cervical dystonia. Contractions cause the head to twist and turn to one side. Or head can pull it forward or backward. The Cervical dystonia, sometimes causing pain.
  • In the eyelids. When the muscles that control the blinking of the eyes are involved, it is called blepharospasm. Rapid flashing or muscle spasms that cause your eyes to close make it difficult to see. Muscle spasms are typically not painful. Could be increased in the bright light or during reading, watching TV or interacting with other people. It may also increase the stress. The eyes may feel dry, sandy or light-sensitive.
  • The mandible, or tongue. When the muscles of the jaw and the tongue are affected, it is called oromandibular dystonia. It can cause difficulty in speaking, drooling, and difficulty chewing or swallowing. This type of dystonia can be painful. Often occurs with cervical dystonia or blepharospasm.
  • The voice box and vocal cords. When the larynx or vocal cords are affected, it is called dystonia, laryngeal. It can cause a sprain or a whisper of a voice.
  • The hand and forearm. Some types of dystonia occur only when you do one activity to another, such as writing or playing a musical instrument. These are known as the writer of the dystonia and dystonia of the musician. The symptoms usually do not occur when the arm is at rest.

When to see a doctor

The first symptoms of dystonia are often mild, occasional, and linked to a specific activity. See a member of your health care team if you are having contractions muscle that you cannot control.

Causes

The exact cause of dystonia is not known. But could involve changes in the communication between nerve cells in several regions of the brain. Some forms of dystonia that are transmitted in families.

Dystonia can also be a symptom of another disease or condition, including:

  • Parkinson's disease.
  • Huntington's disease.
  • Wilson's disease.
  • Traumatic brain injury.
  • Birth injury.
  • Stroke.
  • Brain Tumor or certain conditions that develop in some people with cancer, known as paraneoplastic syndromes.
  • The lack of oxygen or carbon monoxide poisoning.
  • Infections, such as tuberculosis or encephalitis.
  • Reactions to certain medications or heavy metal poisoning.

Risk factors

The risk for dystonia increases if you have a family history of movement disorders. Women also have a higher risk. They have dystonia twice as often as men.

Another risk factor for the dystonia is to have a condition that causes dystonia, such as Parkinson's disease or Huntington's disease.

Complications

Depending on the type of dystonia, complications can include:

  • Physical disabilities that affect daily activities or specific tasks.
  • Problems with vision.
  • Difficulty moving the jaw, swallowing or speaking.
  • The pain and fatigue of constant contraction of its muscles.
  • Depression, anxiety and social isolation.

Diagnosis

To diagnose dystonia, your healthcare team will start with a medical history and physical examination.

To find the conditions that may be causing your symptoms, you might need:

  • Blood or urine tests. These tests can reveal signs of toxins or of other conditions.
  • MRIorCTscan. These imaging tests to look for changes in your brain, such as tumors or evidence of a stroke.
  • Electromyography (EMG). This test measures the electrical activity in the muscles.
  • The genetic testing. Some forms of dystonia are associated with certain genes. Know if you have these genes may help to guide treatment.

Treatment

To manage dystonia, your health care professional may recommend a combination of medication, therapy, or surgery.

Medications

Injections of botulinum toxin (Botox, Dysport, other) on the specific muscles could reduce or stop muscle spasms. Injections are usually repeated every 3 to 4 months.

The side effects are generally mild and temporary. They may include weakness, dry mouth or changes in the voice.

Other over-the fate of chemicals in the brain called neurotransmitters that affect the movement of the muscles. The options include:

  • Carbidopa-levodopa (Duopa, Rytary, other). This medication can increase the levels of the neurotransmitter dopamine. Levodopa can also be used as a test to help diagnose certain types of dystonia.
  • Trihexyphenidyl and benztropine. These two medications that act on other neurotransmitter dopamine. Side effects can include memory loss, blurred vision, drowsiness, dry mouth, and constipation.
  • Tetrabenazine (Xenazine) and deutetrabenazine (Austedo). These drugs block dopamine. Side effects may include sedation, nervousness, depression, or insomnia.
  • Diazepam (Valium, Diastat, others), clonazepam (Klonopin), and baclofen (Lioresal, Gablofen, other). These drugs reduce neurotransmission and might help some forms of dystonia. May cause side effects, such as drowsiness.

Therapy

You may also need:

  • The physical therapy or occupational therapy, or both, to help relieve symptoms and improve function.
  • Speech therapy if the dystonia affects your voice.
  • Stretching, or massage to relieve muscle pain.

Surgery

If your symptoms are severe, surgery may help. There are some types of surgery for the treatment of dystonia:

  • The deep brain stimulation. The electrodes surgically implanted in a specific part of your brain and is connected to a generator implanted in your chest. The generator sends electrical impulses to your brain that can help to control your muscle contractions. The configuration of the generator can be adjusted to treat your specific condition.
  • Denervation selective surgery. This procedure involves cutting the nerves that control the muscle spasms. Could be an option when other treatments for cervical dystonia have not worked.

Lifestyle and home remedies

Dystonia does not have a cure, but you can do several things to manage the symptoms:

  • Sensory tricks to reduce spasms. Touching certain parts of your body can cause spasms to stop temporarily.
  • The heat or the cold. The application of heat or cold can help relieve muscle pain.
  • The management of stress. Learn effective strategies for managing stress, such as deep breathing, the social support and positive self-talk.

Alternative medicine

Alternative treatments for dystonia have not been well studied. Ask your health care team about complementary treatments before you start them. Consider:

  • The meditation and the deep breathing. Both have the potential to alleviate the stress that can worsen spasms.
  • Biofeedback. A therapist uses electronic devices to control the functions of the body, such as muscle tension, heart rate, and blood pressure. You then learn to control the body of answers, which can help reduce muscle tension and stress.
  • Yoga. Yoga combines physical postures, breathing techniques, and meditation or relaxation.

Coping and support

Living with dystonia can be difficult and frustrating. Your body may not always move as you want, and you can be uncomfortable in social situations. You and your family may find it helpful to talk with a therapist or join a support group.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the nervous system, known as a neurologist.

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all your medications, vitamins and supplements.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Ask a relative or friend to accompany you, to help you remember what your provider tells you.
  • Write questions to ask their health professional.

Questions to ask your health care professional

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need? Does not require special preparation?
  • Is my condition likely temporary or chronic?
  • What treatments are available?
  • What side effects can I expect from these treatments?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask, please do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your health care professional may ask you some questions. Be prepared to respond to them can give more time to concentrate on your concerns. You may ask:

  • When did you first notice your symptoms?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Anyone in your family ever been diagnosed with dystonia?
Symptoms and treatment of Dystonia