Dystonia

Overview

Dystonia is a movement disorder that causes the muscles to contract. This can cause twisting motions or other movements that happen repeatedly and that aren't under the person's control.

When the condition affects one part of the body, it's called focal dystonia. When it affects two or more areas of the body next to each other, it's called segmental dystonia. When dystonia affects all parts of the body, it's known as general dystonia. The muscle spasms can range from mild to more serious. They may be painful, and they can affect the person's ability to complete daily tasks.

There's no cure for dystonia, but medicines and therapy can improve symptoms. Surgery is sometimes used to disable or regulate nerves or certain brain regions in people with serious dystonia.

Symptoms

Dystonia affects different people in different ways. Muscle spasms might:

• Begin in a single area, such as your leg, neck or arm. Focal dystonia that begins after age 21 usually starts in the neck, arm or face. Although it tends to remain in the single area, it may spread to a neighboring area of the body.
• Occur during a specific action, such as writing by hand.
• Worsen with stress, fatigue or anxiety.
• Become more noticeable over time.

Areas of the body that can be affected include:

• Neck. When the neck muscles are involved, it's called cervical dystonia. Contractions cause the head to twist and turn to one side. Or the head may pull forward or backward. Cervical dystonia sometimes causes pain.
• Eyelids. When muscles controlling eye blinks are involved, it's called blepharospasm. Rapid blinking or muscle spasms that cause your eyes to close make it hard to see. The muscle spasms usually aren't painful. They might increase in bright light or while reading, watching TV or interacting with people. They also might increase under stress. The eyes might feel dry, gritty or sensitive to light.
• Jaw or tongue. When the muscles of the jaw and tongue are affected, it's called oromandibular dystonia. It can cause slurred speech, drooling, and trouble chewing or swallowing. This type of dystonia can be painful. It often occurs with cervical dystonia or blepharospasm.
• Voice box and vocal cords. When the voice box or vocal cords are affected, it's called laryngeal dystonia. It can cause a strained or whispering voice.
• Hand and forearm. Some types of dystonia occur only while doing an activity over and over, such as writing or playing a musical instrument. These are known as writer's dystonia and musician's dystonia. Symptoms usually don't happen when the arm is at rest.

When to see a doctor

Early symptoms of dystonia often are mild, occasional and linked to a specific activity. See a member of your healthcare team if you're having muscle contractions that you can't control.

Causes

The exact cause of dystonia isn't known. But it might involve changes in communication between nerve cells in several regions of the brain. Some forms of dystonia are passed down in families.

Dystonia also can be a symptom of another disease or condition, including:

• Parkinson's disease.
• Huntington's disease.
• Wilson's disease.
• Traumatic brain injury.
• Birth injury.
• Stroke.
• Brain tumor or certain conditions that develop in some people with cancer, known as paraneoplastic syndromes.
• Lack of oxygen or carbon monoxide poisoning.
• Infections, such as tuberculosis or encephalitis.
• Reactions to certain medicines or heavy metal poisoning.

Risk factors

Your risk for dystonia increases if you have a family history of the movement disorder. Women also have a higher risk. They have dystonia twice as often as men do.

Another risk factor for dystonia is having a condition that causes dystonia, such as Parkinson's disease or Huntington's disease.

Complications

Depending on the type of dystonia, complications can include:

• Physical disabilities that affect daily activities or specific tasks.
• Trouble with vision.
• Trouble moving the jaw, swallowing or speaking.
• Pain and fatigue from the constant contraction of your muscles.
• Depression, anxiety and social withdrawal.