Dystonia

Dystonia hands

Last Updated February 20th, 2019

Overview of Dystonia

Problems in muscle tone have become very common in the recent times. These conditions are affecting the lives of millions across the globe. The World Health Organisation (WHO) reports that about 50% of the current global population suffers from different forms of musculoskeletal disorders. Dystonia is a muscular disorder of serious nature that causes involuntary and unregulated muscle movements. At present, around 5,00,00 people in the US and Canada are suffering from acute forms of Dystonia. This has definitely contributed to the increasing global burden of muscular health problems.

 

What is Dystonia?

Dystonia musclesDystonia is a collective term for a group of muscular disorders that cause sustained muscular contractions, unregulated muscle movements, repeated contractions and awkward postures. The onset may occur as a mild tremor in the muscles. With the gradual progression of the disease, which usually occurs within a very short time, an overflow of the symptoms may occur to the adjacent muscles. Dystonia may cause a compulsive twisting of a person’s arms behind his back or a forceful bending of the head towards the chest. It may arise from multiple environmental, genetic or certain clinical factors. The parts of the body that are normally affected by Dystonia are- eyes, arms, neck, swallowing muscles, vocal cords, jaw, and face. People suffering from Parkinson’s disease are often found to develop Dystonic symptoms.

 

What are the main causes of Dystonia?

Dystonia is an acute muscular condition that is precipitated by a myriad of aetiological factors. The most commonly studied causes are given below-

  • Genetic defects that are present at birth, caused by mutations in the MR-1, PRRT2, SGCE and ATP1A3 genes
  • Diseases like Parkinson’s disease, Huntington’s disease, Wilson’s disease and Multiple Sclerosis
  • Past injuries to the spine or the skull
  • Past infections such as Encephalitis, Tuberculosis or HIV
  • The occurrence of brain tumors
  • Toxicity caused by carbon monoxide
  • Medications like anticonvulsants, antipsychotics, and other neuroleptic drugs
  • Past occurrence of cerebral palsy or stroke
  • Congenital defects in the brain structure or certain birth injuries
  • Acute oxygen deprivation
  • Malfunctioning of the sodium-potassium pump in the body

 

What are the symptoms of Dystonia?

Dystonia handsDystonia is often mistaken for convulsive fits. A knowledge of the following dystonic symptoms if essential in order to facilitate accurate diagnosis and treatment –

  • Neck: Dystonia affecting the neck is called Cervical Dystonia. Here the head is pulled close to the chest, causing twisting and painful bending of the neck.
  • Eyelids: Involuntary spasms of the eyes, causing a rapid blinking of the eyelids. These are called “Blepharospasms”. These contractions increase in bright light or under stressful conditions. The eyes may feel extremely dry after a series of contractions. The repeated occurrence of these contractions can make a person functionally blind.
  • Jaw and tongue: Dystonia affecting the tongue and the jaw is known as Oromandibular dystonia. The common manifestations are- problems in chewing and swallowing, drooling and slurred speech. This condition may occur in parallel with Cervical Dystonia and Blepharospasms.
  • Voice box and vocal cords: It is known as Spasmodic Dystonia. The patient’s voice may sound very tight and whispery.
  • Hand and forearm: This is a relatively milder form and occurs due to certain repetitive activity such as playing a musical instrument continuously (Musician’s Dystonia) or writing continuously (Writer’s Dystonia).

 

What are the different types of Dystonia?

Dystonia is categorised into the following types, based on their clinical characteristics-

  • Generalised Dystonia: It is usually present at birth and is mainly an autosomal dominant disorder. It originates in the lower limbs and radiates in the upward direction. It is often called torsion dystonia or idiopathic torsion dystonia. A few examples of this type of Dystonia are- dystonia musculorum deformans, Oppenhiem and Flatau-Sterling syndrome.
  • Focal Dystonia: It is a neurological condition characterized by involuntary muscular contractions and abnormal body postures. It has the following subtypes-
  • Anismus: It causes involuntary contractions of the rectus muscles. The patients experience constipation and painful bowel movements. The conditions may often worsen to give rise to Encopresis.
  • Cervical dystonia: It is also known as spasmodic torticollis and mainly affects the neck muscles. It causes the patient’s head to rotate to one side.
  • Blepharospasm: It occurs due to rapid contractions of the muscles around the eye(s). The person experiences involuntary blinking and often a forced closure, that may eventually lead to functional blindness.
  • Oculogyric problem: In this case, the muscles of the head and the eyes are affected. The patient may experience an upward deflection of the eyes. Diplopia (double vision) may occur in certain cases.
  • Oromandibular dystonia: It causes contractions of the mouth and tongue muscles.
  • Laryngeal dystonia: A hoarse or a whispered voice results due to dysfunctions of the laryngeal muscles.
  • Focal hand Dystonia: It arises due to overuse of the group of small muscles in the hand due to repeated typing or writing.
  • Segmental dystonia: It usually affects any two adjoining region of the body. It is of the following types-
  • Hemidystonia: It affects one arm and one foot unilaterally.
  • Multifocal dystonia: It affects multiple adjoining parts of the body.
  • Generalised dystonia: It affects a major portion of the body, mainly the back and the legs.
  • Genetic dystonia: These are mainly autosomal dominant diseases and occur due to mutations in the ATP1A3, PRKRA, GCH1 and the ANO3 genes. There exists a group of genetic dystonia known as Myoclonic dystonia which arise from a missense mutation in the Dopamine-D2 receptor.

 

Diagnosis, treatment, & prevention

Dystonia leg crampsImaging tests (MRI and CT scan) and genetic tests are critical in determining the root cause of Dystonia. Doctors usually prescribe medicines like- anticholinergics, baclofen, botulin toxin, clonazepam and certain medications for Parkinson’s.

The treatment method often includes a multi-disciplinary approach to ensure effective improvements in the patient’s condition. This comprises of medications, physical therapy, and even surgery if it is required.  The most effective drug in treating dystonia is Botox (Botulinum toxin), which is injected to the muscles which exhibit tremors and abnormal movements.  The numbing effect is temporary hence the process is repeated every 3-4 hours.  Other medicines used to alleviate the symptoms are the ones which target the neurotransmitters in the brain, facilitating proper muscles movements. In addition to these,  a patient should also refer to speech therapy and physiotherapy. In extreme cases, surgeries such as Deep Brain Stimulation may be performed that send regulated electric signals to the brain.

There are no known causes for primary dystonia, hence no preventive measures. But secondary or acquired dystonia can be prevented by reducing exposure to environmental toxins such as tobacco smoke. Maintaining healthy eating patterns and reducing stress can also be helpful.

 

Facts

  • The visible symptoms of dystonia such as rapid eye movements and muscular tremors appear more elevated under stressful conditions.
  • While the exact cause is still unknown, many studies point to the fact that it may be caused due to damage to the basal ganglia in the brain.

Facts

  • Botox is considered as a popular and effective therapy for treating dystonia symptoms.
  • Dystonia has no direct effect over cognitive powers of an individual but it might be comorbid with depression and anxiety.

Facts

  • Several cases of acquired dystonia can be traced back to birth injuries such as hypoxia (acute shortage of oxygen) or even neonatal brain haemorrhage.

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Dos and Don'ts

Dos
  • Try to gain as much knowledge and awareness about the condition.
  • Treat the associated mental conditions of depression and anxiety to witness improvements in the symptoms.
  • Consume a well-balanced and nutritious diet. Also, get adequate amount of sleep.
Don'ts
  • Let dystonia stand in your way of achieving a sense of identity and accomplishment.
  • Limit your treatment of dystonia to just one specific field of treatment. Refer to a number of experts, ranging from neurologist to physiotherapists to gain maximum improvement.

 

 

 

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8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…