Movements may be slow, balance may be difficult to maintain, and a tremor may occur in the hands during rest.
Symptoms lessen dramatically when people are given low doses of levodopa. If levodopa relieves the symptoms, the diagnosis is confirmed. Drugs used to treat nausea or psychosis sometimes cause abnormal sustained muscle contractions dystonias. If doctors suspect that a disorder is causing the dystonia, they may do tests to identify the cause, such as computed tomography CT or magnetic resonance imaging MRI. Correcting or eliminating the cause of dystonia, if known, usually reduces the spasms.
For example, drugs used to treat multiple sclerosis may reduce spasms related to that disease. When dystonia is due to use of an antipsychotic drug, promptly taking diphenhydramine by injection or by mouth usually stops the spasms quickly, and the antipsychotic is stopped.
Drugs, the most common medical intervention, are an important part of medical care for older people. Without drugs, many older people would function less well or die at an earlier age. These drugs reduce spasms by blocking specific nerve impulses involved in causing the spasms.
However, anticholinergic effects of these drugs also include confusion, drowsiness, dry mouth, blurred vision, dizziness, constipation, difficulty urinating, and loss of bladder control, which are troublesome, especially in older people. A benzodiazepine a mild sedative such as clonazepam , baclofen a muscle relaxant , or both are also usually given. Baclofen may be given by mouth or by a pump implanted in the spinal canal.
If generalized dystonia is severe or does not respond to drugs, deep brain stimulation may be done. For this procedure, tiny electrodes are surgically implanted in the basal ganglia collections of nerve cells that help initiate and smooth out voluntary muscle movements. The electrodes send small amounts of electricity to the specific area of the basal ganglia that causes dystonia and thus help lessen symptoms.
Some people, especially children with dopa-responsive dystonia, improve dramatically when they are treated with levodopa plus carbidopa. If one or a few body parts are affected, botulinum toxin a bacterial toxin used to paralyze muscles or to treat wrinkles is injected into the overactive muscles.
Botulinum weakens the muscle contraction but does not affect the nerves. These injections are particularly useful for blepharospasm and spasmodic torticollis. However, injections must be repeated about every 3 to 4 months because botulinum toxin becomes less effective over time.
In a few people who are repeatedly given to botulinum injections, the body produces antibodies that inactivate the toxin. If the affected muscles are tiny or deep in the body, electromyography Electromyography and Nerve Conduction Studies Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination.
Electroencephalography EEG is a simple, painless procedure in which Merck and Co. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge.
This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Types and Symptoms. Focal and segmental dystonias Generalized dystonias. Movement Disorders. Test your knowledge. Bell palsy is sudden weakness or paralysis of the muscles on one side of the face due to malfunction of the seventh cranial nerve. This nerve moves facial muscles, stimulates salivary and tear glands, detects tastes, and controls a muscle involved in hearing.
Which of the following is often the first symptom of Bell palsy? More Content. Dystonia By Hector A. There's no cure for dystonia. But medications can improve symptoms.
Surgery is sometimes used to disable or regulate nerves or certain brain regions in people with severe dystonia. Early signs of dystonia often are mild, occasional and linked to a specific activity. See your doctor if you're experiencing involuntary muscle contractions.
The exact cause of dystonia isn't known. But it might involve altered nerve-cell communication in several regions of the brain. Some forms of dystonia are inherited. Dystonia care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
This content does not have an Arabic version. Overview Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Comella C. Classification and evaluation of dystonia. Accessed Sept. Flint PW, ed. Secondary dystonia is where dystonia occurs as a symptom of an underlying condition or injury. Read more about the causes of dystonia. Dystonia is diagnosed by a specialist examining and recognising the typical symptoms.
The type of dystonia is then classified by which area of the body is affected. When diagnosing dystonia, it's important to confirm whether you have primary or secondary dystonia, because this may determine the type of treatment you need.
If you have typical signs of late-onset focal dystonia, specific investigations may not be required. However, tests may be needed to confirm whether you have primary or secondary dystonia. These may include brain scans, urine or blood tests , and genetic testing. Read more about how dystonia is diagnosed. Treatment will vary, depending on the type of dystonia you have and the precise nature of your symptoms.
However, the four main types of treatment are:. Read more about how dystonia is treated. Dystonia is an unpredictable condition. It tends to progress slowly and the severity of a person's symptoms can vary from one day to another. Focal dystonia usually progresses gradually over a period of about five years and then doesn't get any worse.
Sometimes, a person's symptoms improve or disappear completely. Total remission is more likely in cases of secondary dystonia, such as dystonia that occurs after a stroke. Dystonia can affect men, women and children. It can be difficult to diagnose, and there may be many people with the condition who remain undiagnosed. The Dystonia Society estimates that at least 70, people are affected by dystonia in the UK.
At least 8, of these are children and young people. In early-onset dystonia, the symptoms begin during childhood or early adulthood.
Symptoms usually start in the legs or arms, before spreading to other limbs and sometimes the upper part of the body. Dystonia that starts as an adult late-onset usually begins in the head, neck or one of the arms, and doesn't progress to affect other parts of the body. Generalised dystonia often begins around the time a child reaches puberty.
The symptoms usually begin in one of the limbs, before spreading to other parts of the body. The symptoms of this type of dystonia usually begin during childhood, between the ages of 6 and 16 years. The most common symptom is an abnormal, stiff way of walking. The sole of the foot can bend upwards or the foot may turn outwards at the ankle. Some people with dopa-responsive dystonia may also have muscle stiffness and spasms in their arms and torso.
Myoclonus dystonia is a rare type of segmental dystonia that affects the muscles in the arms, neck and torso. Segmental dystonia affects two or more connected parts of the body. It causes sudden "jerk-like" spasms myoclonus that are similar to the spasms someone has when they get an electric shock. Paroxysmal dystonia is a rare type of dystonia, where muscle spasms and unusual body movements only occur at certain times.
The sudden onset of symptoms is known as an attack. The symptoms of paroxysmal dystonia can be similar to the symptoms of an epileptic fit. However, during an attack, only your muscles will be affected.
Unlike epilepsy , you won't lose consciousness and you'll remain fully aware of your surroundings. Attacks can last from a few minutes to several hours. Cervical dystonia, also known as torticollis, is the most common form of dystonia. It's a type of focal dystonia where only one body part is affected that affects the neck muscles. Involuntary contractions and spasms in the neck muscles can range from mild to severe and cause your head and neck to twist or be pulled forwards, backwards or from side to side.
The symptoms of cervical dystonia can sometimes be relieved by touching your chin, neck or the back of your head. The reasons for this are unclear. Blepharospasm is a type of focal dystonia that causes the muscles around your eyes to spasm involuntarily. Uncontrollable eye closure is a common characteristic of blepharospasm.
In the most severe cases, a person may be unable to open their eyes for several minutes, effectively making them blind for short periods of time. Frequent blinking, eye irritation and sensitivity to light photophobia are also possible characteristics of blepharospasm.
If you have blepharospasm, the pattern of your symptoms can change throughout the day. For example, you may have few or no symptoms when you wake up in the morning, but they may start to appear or get worse when you're tired or stressed. Although it isn't considered to be a dystonia, hemifacial spasm can cause similar symptoms, with repetitive twitching of the muscles on one side of the face, usually around the eyes and mouth.
It can respond well to botulinum toxin injections. Laryngeal dystonia is a type of focal dystonia that causes the muscles of the voice box larynx to spasm. Your voice can either sound "strangled" or very quiet and "breathy", depending on whether the muscles of your larynx spasm outwards or inwards.
This makes handwriting difficult and uncomfortable. Other less well-known types of task-specific dystonia include:. Oromandibular dystonia is a type of segmental dystonia that affects the lower facial muscles, tongue or jaw. It can cause a number of different facial distortions, including grimacing and lip pursing. The jaw can repeatedly open and close or pull outwards and upwards. Tongue movements can be continuous or occur intermittently. In some cases, the symptoms of oromandibular dystonia only occur when your mouth is being used, such as while eating or talking.
In other cases, the symptoms may be improved by talking or chewing. If you have oromandibular dystonia, you may also have difficulty swallowing dysphagia. Dystonia with no obvious cause, or caused by a genetic mutation, is known as primary dystonia. If dystonia is a symptom of another condition, it's known as secondary dystonia. Most people with primary dystonia don't have an identified cause. A minority of cases are associated with genetic mutations, which usually begin in childhood.
There are currently over 12 types or sub-types of dystonia linked to genetic mutations, including generalised dystonia, dopa-responsive dystonia and paroxysmal dystonia. Read more about the different types of dystonia. The genes responsible for these types of dystonia are passed down through families in a pattern that's known as autosomal dominant.
This means if you have one of these abnormal genes, there's a one in two chance your children will inherit that gene and develop dystonia. Diagnosing dystonia isn't straightforward. It involves using a stepwise approach that starts by identifying the precise nature and specific features of your movement disorders. The specialist will try to identify which type of dystonia classification your movement disorders fall into, taking into consideration a number of factors, including:.
It's important to confirm whether you have primary or secondary dystonia to help determine the type of treatment you need.
0コメント