Dystonia

• Based on the affected body part
  • Generalized dystonia (affects all or most body parts)
  • Focal dystonia (affects one body part)- blepharospasm, cervical dystonia, oromandibular dystonia, truncal dystonia, and writer’s cramp
  • Multifocal dystonia (affects ≥2 unrelated body parts)
  • Segmental dystonia (affects ≥2 adjacent body parts)
  • Adult-onset dystonia is generally focal, whereas those beginning in childhood may become generalized.
• Based on the cause
  • Inherited- caused due to gene mutation
  • Acquired- secondary to drug, brain injury, stroke, infection, metabolic
  • Idiopathic- no clear cause
• Based on the symptoms
  • Dopa- responsive dystonia improves dramatically with dopamine supplementation
  • Myoclonus dystonia
  • Paroxysmal dystonia
  • Tardive dystonia
  • Functional dystonia

People with dystonia may experience:

• Muscle spasms or cramps
• Postural deformities
• Difficulty in speaking, chewing, swallowing, walking, and writing
• Abnormal eye blinking/ contraction of face
• Bending or twisting of the body

The exact cause is unknown, but may be linked to:

• Dysfunction of basal ganglia (a brain region controlling movement)
• Genetic factors
• Brain injuries
• Infections or metabolic conditions

Doctors use the following to confirm diagnosis and rule out other causes:

• Clinical evaluation: observing posture and movements
• Genetic testing: to identify inherited dystonia
• MRI Brain and PET scan: for acquired and degenerative causes

Although there is no complete cure, treatments can reduce symptoms and improve quality of life:

• Medications (anticholinergics, dopamine blockers)
• Botulinum toxin injections for focal dystonia
• Physical therapy and rehabilitation to improve muscle control
• Surgery (deep brain stimulation) for severe cases not responding to medicines
• Lifestyle modification (stress management, regular exercises)

Seek medical attention if you notice:

• Persistent involuntary twisting or abnormal posture
• Difficulty with speech, writing, chewing, or walking

Dystonia cannot always be prevented, but risk can be reduced by:

• Avoiding long-term use of certain medications without medical supervision
• Managing risk factors like stroke, infections, and head injuries

For diagnosis and management of dystonia, consult a Neurologist (specialist in brain and nerve disorders).