Dystonia is a neurological movement disorder characterized by involuntary repetitive and twisted postures and motions, caused by contractions and expansions by opposing muscles.
Many different types and categories of dystonia exist. For example, dystonia that begins early on in life is called childhood-onset dystonia. There is also adolescent-onset and adult-onset.
Dystonia can also be categorized as:
Focal dystonia — the awkward and irregular movements are centered in only one part of the body. The most common type, focal dystonia includes: cervical dystonia (affecting neck muscles), blepharospasm (located in the eye), oromandibular dystonia (involving the jaws and tongue) and other body-specific conditions.
Multi-focal dystonia — the disorder is located in two or more body parts.
Segmental dystonia — adjacent areas of the body are affected.
Hemidystonia — only one side of the body is affected.
Generalized dystonia — dystonia is spread through more than one region of the body.
Causes and Symptoms of Dystonia
Dystonia causes can be categorized as primary, secondary, dystonia-plus or Heredodegenerative:
Primary — considered idiopathic, it has no known cause but may have genetic roots. Secondary — dystonia that is acquired from known conditions such as:
trauma to the brain,
or symptoms of another disease.
Dystonia-Plus syndrome — associated with another movement disorder such Parkinson’s disease. Heredodegenerative — occurring with other neurological disorders.
Early symptoms of dystonia can initially be small occurrences that materialize only after sustained fatigue, stress or physical exertion:
involuntary rapid eye blinking or spasms that close the eye
dragging, turning or cramping of the foot
neck pulling or turning
The progression of the disorder is variable. In advanced stages, the symptoms and contractions may become more pronounced:
rigid posture deformation
contortion of the spine
quick, repetitive twists and movements
Pain and disability may occur as a result of spine and joint degeneration caused by these unusual movements and awkward postures. Depression can also result from feelings of embarrassment.
How Is Dystonia Diagnosed?
A movement disorder neurologist can provide an accurate diagnosis, with a physical examination, review of your medical history, blood tests and brain scans.
What Are Non-Surgical Treatments for Dystonia?
A multidisciplinary team can provide expert dystonia treatments that focus on pain abatement and reducing muscle contractions and posture torsion (twisting).
Non-drug therapies such as physical therapy, occupational therapy, aquatic therapy and stress reduction techniques may be beneficial.
Drug therapies may include neurotransmitter blockers such as dopaminergics (blocks dopamine), anticholinergics (blocks acetylcholine) and botulinum neurotoxin (also blocks acetylcholine, one form is called Botox). Baclofen may also be used to help regulate GABA-B. By interrupting the neurotransmitters, the messages to the brain are disrupted and symptoms are lessened.
However, if your dystonia is resistant to drug and non-drug therapies, surgical treatments may provide improved results.
Expert Surgical Treatments for Dystonia at NSPC
Neurological Surgery, P.C. (NSPC) has offices throughout New York’s Queens, Nassau and Suffolk Counties to provide expert brain treatments for a variety of movement disorders. Our neurosurgeons provide the best state-of-the-art surgical options for brain-related issues.
Using microelectrode recordings, a neurosurgeon may be able to pinpoint the area of the brain responsible for the involuntary movements. The thalamus and globus pallidus of the brain may be responsible, and therapeutic lesioning of those areas may lessen symptoms. Thalamotomy — a small part of the thalamus is targeted. A therapeutic lesion is used to damage the pathways and provide relief of involuntary movements and tremors. Pallidotomy — also uses image-guided surgery to target part of the globus pallidus, to lessen symptoms and provide relief from certain kinds of dystonia. Peripheral denervation — targets the nerves and muscles at the site of the dystonia.
Deep brain stimulation (DBS) — is a form of neuromodulation that pulses an electrical current deep inside the brain where movement communication is located.
NSPC’s multi-disciplinary teams include DBS-trained movement neurologists, pain management specialists, neuroradiologists, neurophysiologists and neurosurgeons, so you get world-class treatment from leading experts in the NY region—including Long Island.