Dystonia is a relatively rare muscle disorder affecting about 1 percent of the population, although it is more prevalent in women than it is in men. The causes are unknown. The disorder, which is marked by involuntary muscle contractions, can be mild to severe, and it can be pain-free or painful. Sometimes the specific muscle group that is affected dictates the level of pain involved.
Dystonia can occur in one specific region, such as an arm, hand, neck, or leg. This is called focal dystonia. It can also spread from one body part to an adjacent one – from a hand to an arm, for example. This is sometimes referred to as multi-focal or segmented or generalized dystonia.
The condition is often related to a specific repeated motion that is tied to a specific task, such as typing or playing a musical instrument. It can also be as specific in location, affecting just the eyelids, for example, a condition marked by rapid, uncontrolled blinking. Similarly, it can affect your jaw, making speaking, chewing, or swallowing difficult.
Age is a factor. When dystonia afflicts persons under 21, the condition tends to remain specific to one or two muscle groups. It has more of a chance of becoming widespread when it attacks older patients.
Any involuntary muscle contractions should be brought to a doctor for an examination at the early stages of development. A physician will call for blood and urine laboratory tests to see if any toxins are present. MRI, CT Scan, or electromyography imaging may be ordered.
The causes of dystonia are also unknown, but there are a variety of possibilities that are defined as conditions that increase the risk of dystonia. These are various illnesses (Parkinson’s disease, Huntington’s disease, Wilson’s disease), injuries (including traumatic brain injuries), infections, tumors, reactions to various medications, and oxygen deprivation.
While there is no specific cure, a variety of treatments are used to mitigate symptoms and slow the progression of dystonia. These include pharmaceutical interventions, physical or speech therapy, and even surgery, which is deployed in severe cases.
Injections of onabotulinumtoxinA, known as Botox, is sometimes used to try to reduce or eliminate symptoms of dystonia. Repeated injections (every three or four months) might be necessary. Concerning side effects include dry mouth and generalized weakness.
Duopa and Rytary. These drugs are designed to increase levels of the neurotransmitter dopamine.
Cogentin also works on neurotransmitters, but not, in this case, dopamine. Side effects include drowsiness, blurred vision, and constipation.
Austedo and Xenazine do the opposite of Duopa and Rytary. These drugs are dopamine blockers. Drowsiness, jittery nerves and insomnia are common side effects.
Valium, Klonopin, Lioresal, and others: reduce or block other neurotransmitters that can calm some muscle contractions.
Physical and Speech Therapy
Physical and speech therapy can be designed to help people learn to adapt to or overcome symptoms of dystonia. Treatment plans are usually designed specifically for each patient.
In extreme cases, surgery is recommended. Selective denervation surgery involves cutting some nerves that control specific muscles to reduce hyperactivity. Surgery is seen as a treatment of last resort in most cases.
When To Seek Help
Do you know someone afflicted with uncontrolled muscle spasms? In San Diego, call Pacific Medical Care at 619-333-8114 to schedule an appointment for a check-up or a referral to a neurologist.