You must have seen people with weird and peculiar movements and postures of the head, limbs, and even the body or abnormal facial grimaces. These are people with a neurological condition called dystonia.
What is Dystonia?
Dystonia is the medical term for a group of disorders that cause involuntary contraction/spasm of the affected muscles (i.e., the muscle squeezes or tenses up even when you are not trying to move them). It can cause part of the body to twist and stay in an unusual position (e.g, the foot might stay turned in so it drags when you walk, or the head might twist to one side and remain in an abnormal posture). Some people have tremors (shaking) of the affected part due to dystonia.
Most commonly dystonia affects specific or limited parts of the body like the neck, face, arm, foot, and trunk (focal dystonia). It may sometime involves several contiguous parts of the body (segmental dystonia), or the whole body (generalized dystonia).
Some dystonia starts in childhood and some in adulthood. Some run in families and some have an unknown cause (Idiopathic). There is dystonia which occurs as a part of other diseases (e.g., Parkinson’s Disease) or as a sequel to an earlier insult to the brain.
Types of Dystonia
- Early onset isolated dystonia – Starts in childhood, usually begins in the legs, and then moves to the trunk and other body parts, and may worsen with time.
- Cervical dystonia – Starts in adulthood, commonly affects neck and shoulder muscles; may be associated with head shaking and pain.
- Blepharospasm – Starts in adulthood, and causes involuntary, forceful eye closure and increased blinking. Bright light and stress may worsen symptoms.
- Oro-mandibular and facial dystonia – Starts in adulthood, and causes problems with the jaw (staying open / clenching / crooked), tongue (involuntary protrusion), unclear speech, and difficulty in swallowing. It may be seen rarely in combination with cervical dystonia or blepharospasm (Meig’s syndrome).
- Spasmodic dysphonia – Starts in adulthood, and affects muscles of the voice box, causing the voice to sound strained / whisper.
- Arm dystonia – Starts in adulthood, and causes abnormal postures of the upper limb and tremors. It may only be present during voluntary movements/postures.
- Task-specific dystonia – Starts in adulthood, and occurs only during certain tasks. Writer’s cramp is the commonest type, where a person’s hand gets twisted only when he attempts to write. Others like typist’s dystonia, musician’s dystonia, and Golfer’s dystonia can also occur.
Dystonia Treatment
There is no cure for dystonia. Treatment can help the symptoms. Treatment can be in the form of medicine or Botulinum toxin injections (which work for 2-4 months). In severe cases who do not respond to the above treatment, Deep brain stimulation (DBS) can be considered. In DBS, a wire is implanted surgically in the part of the brain which modulates movements and is connected to a device implanted under the skin near the collar bone. It sends signals to the brain and reduces muscle spasms. You can consult experienced and top neurologists for the best advice and help.
