Dystonia is a neurologic syndrome characterized by involuntary, sustained, patterned and often repetitive muscle contractions of opposing muscles causing twisting movements or abnormal postures. In some situations, the dystonia may affect many different muscle groups throughout the body. In other situations, the dystonia may be more focal, i.e., involving limited muscle groups, such as in the neck or face region. When chronic, this is a rather disabling condition.
Cause of Dystonia
There are many possible causes for dystonia. In many cases, we may not be able to identify a specific cause. Some types of dystonia are hereditary. Dystonias may also be a manifestation of other medical conditions or result as a side effect of certain medications. The abnormal muscle tone may also follow an injury. Dystonias were once thought to have a psychiatric cause, which we no longer believe.
Diagnosis of Dystonia
The diagnosis of dystonia is clinical. That is to say, there are no specific tests that lead to this diagnosis. Medical testing in the form of blood tests or brain imaging (MRI) may be performed to look into potential causes for the dystonia, though they don’t generally add much to the diagnosis.
Treatment of Dystonia
Unfortunately, dystonia cannot usually be “cured.” The treatment of dystonia is directed towards reducing the symptoms of the sustained muscle contractions. Physical therapy is often utilized to stretch, relax and strengthen muscle groups. Medications are often used in the treatment of dystonia. Some medications work within the brain itself to try to suppress the abnormal muscle activity, while other medications may have a more direct effect on muscle relaxation. Side effects of these medications often include tiredness. Botulinum toxin injection (Botox) has become a first-line treatment for many types of dystonia. Typically, this is most useful for dystonias that involve face or neck muscles. Botulinum toxin works by producing relaxation in the muscle groups into which it is injected. Side effects of botulinum toxin injections are usually minor. The typical duration of benefit of the botulinum toxin injections is three months, occasionally longer.