Dystonia causes sustained muscle contractions that result in involuntary movements, cramps and twists. Especially extremities and the trunk are affected. Dystonia is sometimes limited to one part of the body (focal dystonia), may also affect adjacent body parts (segmental dystonia) or – rarely – even the whole body (generalized dystonia). Dystonia may occur temporarily or sustained.
The most frequent type of dystonia is focal dystonia of the face (eyelid cramp, blepharospasm) and the throat with often painful malposition of the head (wry neck, torticollis spasmodicus). Dystonia may also negatively affect or even make it impossible to chew, write, make music or walk due to the strong sustained muscle contractions in the affected body parts.
Symptoms of dystonia in short:
- temporary or sustaining contractions, twists, cramps of muscles
- especially in extremities and trunk
- affecting one part of the body, adjacent parts of the body or even the whole body
- most frequent type of dystonia is focal dystonia of the face (eyelid cramp, blepharospasm) and the throat with often painful malposition of the head (wry neck, torticollis spasmodicus)
- dystonia may also aggravate chewing, writing, making music, walking or make it impossible
The exact cause of dystonia is not known. However, it is assumed that the dopamine production/transmission is not properly working around basal ganglia. These regions in the brain do contribute to movements but also cognitive or emotional processes. Dystonia may also be a sign of other neurological or general diseases making additional examinations necessary.
The diagnosis dystonia necessitates a comprehensive neurological-orthopedic examination. Often imaging procedures like MRI are used to differentiate different diseases that may cause similar or the same symptoms like dystonia.
Focal dystonia (affecting on part of the body) or segmental dystonia (affecting adjacent body parts) is treated with injections. Botulinum toxin is injected into to affected muscles resulting in a blockade of pathologic nerve impulses of the brain to the dystonic muscles. There are also further drugs in use to support dystonia treatment.
In case of severe dystonia, especially the generalized dystonia (affecting the whole body), deep brain stimulation (DBS) can lead to significant improvement of the condition. DBS treats pathologically changed brain structures by transmitting electrical impulses that stimulate or deactivate the corresponding area of the brain. The necessary electrodes are implanted during the minimally invasive, stereotactic brain surgery.
Read more about deep brain stimulation (DBS) as a treatment option of dystonia