Dystonia is a neurological disorder. This is where a person’s body part moves involuntarily creating abnormal body posture and movements. This happens due to uncontrollable muscle contractions.
Dystonia can affect muscles or a group of muscles. This disease occurs due to the unhealthy function of area of brain called basal ganglia. Basal ganglia controls the coordination of movements in the body. There are various types of dystonia.
Women are more prone to dystonia than men. About 1% of the population, globally, is affected by dystonia. It is the third most prevalent movement disorder.
The symptoms of dystonia include abnormal and involuntary muscle contractions. This condition can be particularly debilitating depending on the severity of the involuntary muscle contractions and the area of the body affected. It can be mild as well as severe and can affect several parts of the body. Some early symptoms of dystonia include:
During childhood, dystonia symptoms mostly begin in the foot and hand. However in an adult, other symptoms start appearing in the upper part of the body and then the whole body. The progression of the symptoms of dystonia is more rapid in children as compared to the adults.
Dystonia is caused due to the unhealthy function of the ganglia in the brain. The nerve cells in the ganglia do not communicate properly with each other, leading to the disorder. The exact reason for dystonia is not known. In some cases, primary dystonia is inherited from parents. Possible causes are
Some of the following factors increase the risk
The anti psychotic drugs and electric therapy act strongly against the dopamine receptors, which increases the risk of dystonia. Other medications that can enhance the risk of dystonia include promethazine, prochlorperazine, metoclopramide. Some antidepressants such as amoxapine can also increase the risk of the disease.
Having antipsychotic drugs for a long time, ranging from months to years can cause dystonia. There is no correlation between the duration of consumption of antipsychotic drugs and the severity of dystonia. Patients with focal dystonia are found to have lesser exposure to antipsychotic medicines than patients with generalised dystonia.
Some complications associated with Dystonia include:
Dystonia is not a very well-known disease. Therefore, a person should make himself well aware of the risk factors, complications, and other aspects of the disease.
Dystonia is a clinical diagnosis which is usually made by a specialised movement disorder neurologist or neurosurgeon. Additional tests may be done to bring clarity into the possible causes.
Dystonia is classified as primary or secondary dystonia. Deep brain stimulation therapy involves sending an electrical signal to the brain. It is an effective treatment method in primary dystonia. Certain genes of dystonia respond better than others to this type of treatment. As such, genetic testing may form part of the evaluation. The main target of the brain for this treatment is the GPi (globus pallidus internus).
Unlike deep brain stimulation procedure for Parkinson’s disease, the effects of surgery for dystonia may not be immediate. It may require some time before which the full effect of stimulation might be obvious. This can at times be up to a year.
For treating dystonia, doctors may recommend medication, surgery, therapy, or a combination of all.
The doctor may recommend an injection of botulinum toxin into the muscle to eliminate involuntary contraction of a muscle. There are also some side effects such as dry mouth, weakness and voice changes.
Some medications that are prescribed include Diazepam, clonazepam, carbidopa-levodapa, and tetrabenazine.
The treating doctor might conduct therapies such stretching antagonistic muscles, relaxing muscles, occupational therapy, speech therapy if vocal cords are affected.
In this procedure, the electrodes are surgically implanted in the brain and a generator is implanted in the chest. The generator sends electrical pulses to the brain which helps to calm down involuntary movement.
There are certain daily routine do’s and don’t’s, a person should keep in mind to manage dystonia: