Dystonia

Dystonia

Dystonia is a neurological movement disorder. People with dystonia experience involuntary muscle spasms and contractions.

Movements are often repetitive and cause unusual, awkward and sometimes painful postures. Tremor (shaking) is often associated with some types of dystonia.

Dystonia can be a condition on its own (primary dystonia). Some people experience dystonia as a symptom of another condition (secondary dystonia).

Symptoms of dystonia

Symptoms of dystonia can include:

• uncontrolled muscle spasms
• parts of your body twisting into unusual positions – like your neck being pulled to the side or your feet turning inwards
• shaking (tremors)
• excessive blinking

The symptoms may be continuous or come and go. They may be triggered by voluntary movements.

Types of dystonia 

There are different types of dystonia.

Generalised dystonia

Generalised dystonia affects all parts of the body.

Focal dystonia

If you have focal dystonia, only one muscle group is affected.

The most common type of focal dystonia is neck dystonia, also known as cervical dystonia. This usually causes the head to be pulled in one direction. This can then affect movement and cause pain.

Other types of focal dystonia can impact:

• your voice (laryngeal dystonia)
• the muscles around your eyes (blepharospasm)
• limbs (like writer’s cramp)

Causes of dystonia

Dystonia is thought to be caused by a problem with the part of the brain that controls movement.

Primary and secondary dystonia may have different underlying causes.

Causes of primary dystonia

Primary dystonia often begins in childhood. This type of dystonia is more likely to have a recognised genetic cause.

Causes of secondary dystonia

You might experience dystonia as a symptom of another condition.

Secondary dystonia might be caused by:

• Parkinson’s disease
• cerebral palsy
• certain medications (like some antipsychotics and some anti sickness medications)
• injury to the brain
• stroke

Diagnosing dystonia

If your GP thinks you have dystonia, they may refer you to a specialist neurologist.

You may need to have tests to confirm whether you have primary or secondary dystonia.

Depending on your symptoms, you might have a blood test or scan.

Treating dystonia

There are treatments that can control the involuntary movements and spasms of dystonia.

You might need to try several treatment options to find out which one works best.

Botulinum toxin

If you have focal dystonia, you might be offered botulinum toxin.

Botulinum toxin is injected into the affected muscles. It blocks the neurotransmitters within the nerve, reducing muscle spasms.

The effects of the injection can last from around 3 months to 6 months.

Medication

Oral medications, like tablets, can be effective for some people with generalised dystonia.

The following are medications which might be used to treat dystonia:

• anticholinergics
• baclofen
• muscle relaxants

Physiotherapy

Depending on the type of dystonia you have, physiotherapy might help you improve your range of movement.

Surgery

You might have surgery if your dystonia symptoms don’t improve with other treatments.