Dystonia

Overview
Symptoms & Diagnosis
Treatment

What is Dystonia?

Dystonia is a movement disorder, meaning it affects parts of the brain that control body movement (motor function). It causes involuntary muscle spasms (contractions), sometimes repeatedly, that can twist the body and be painful.

Dystonia symptoms often start in childhood or early adulthood and can range from mild to severe.

Causes of dystonia

In about half of all cases, dystonia is a symptom of a disease or is caused by exposure to toxins or certain drugs. In most other cases where dystonia is not linked to a specific illness or problem, it is thought to have a hereditary link.

This condition might have a connection to a problem in the brain’s basal ganglia, a group of structures in the brain involved in coordination and movement. Acquired dystonia could be the result of:

Tumors
Brain trauma
Stroke
Oxygen deprivation
Reactions to drugs

Many cases of dystonia are temporary, such as those brought on by medication. Although there is no cure for dystonia, several treatment options can help control symptoms and allow people to live independently.

Dystonia treatment options

Dystonia treatment options include:

Drugs and medication
Physical therapy
Surgery

People whose symptoms do not respond well to other treatments may be candidates for deep brain stimulation at UPMC.

Diagnosing Dystonia

Dystonia can affect one muscle, a group of muscles (such as arms or legs), or the entire body.

Dystonia symptoms

Your doctor will ask you about your symptoms, which may include:

Muscle spasms
Shaking (tremors)
Repetitive movements
Difficulty controlling hands or poor handwriting
Difficulty speaking
Foot cramps
Dragging foot

Identifying the type of dystonia

To determine what form of dystonia you have, four factors will be taken into consideration:

Age when symptoms began
Body part(s) affected
Cause of the dystonia, if known
Symptoms of other neurological disorders

Dystonia Treatments

Although dystonia is a chronic condition and the symptoms can be severe, most dystonia does not impact a person’s intelligence, cognition, or life span.

Dystonia treatment options depend on the severity of symptoms and take into consideration any related conditions you have.

Medication, therapy, and complementary treatments

Medications and physical therapy, including voice therapy, are often the first treatment approaches for dystonia.

Drugs that help one person may not help another, so your doctor will work with you to determine the formulation best suited to your case.

In addition to oral medication, injection of botulinum neurotoxin into muscles affected by dystonia may also be used.

Other helpful treatments may include:

Relaxation exercises
Gentle exercise including yoga.

Surgery for dystonia

In order to limit or stop involuntary muscle spasms and lessen pain, doctors can operate:

At the site of dystonic symptoms (such as muscles or nerves in the legs)
In the basal ganglia of the brain, where the signals to move the body originate.

In this type of surgery, selected nerves or abnormal brain tissue are destroyed and/or removed.

Deep brain stimulation

UPMC is a leader in treating movement disorders such as dystonia with deep brain stimulation (DBS), and now offers both standard and MRI-guided DBS, depending on your condition.

Deep brain stimulation delivers electrical stimulation to targeted areas in the brain that control movement, blocking the neuronal signals that cause abnormal movement. DBS gives significant benefit in about 70 percent of people who undergo the procedure.

Options for Deep Brain Stimulation
Dr. Mark Richardson discusses patient options for deep brain stimulation at UPMC.

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