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Dystonia |
Basic Information
Dystonia is a general term for abnormal muscular tone. There
are many clinical manifestations including muscular spasm,
tightening of muscles, tremor, and abnormal movements, such
as twitching, jumping, or writhing. There are many specific
forms of dystonia. Common types include facial spasm, neck
spasm (torticollis), writers cramp, and post-stroke spasm
of a limb. There are also more complex, generalized forms
of dystonia that are usually inherited. The underlying cause
of dystonia is not well understood, but it is usually felt
to originate within the brain itself, and is not a specific
disease of the muscles or nerves. Treatment has in the past
has been directed at affecting brain transmitter levels. More
recently, injections of botulinum toxin have proved to be
very effective.
Symptoms
- Facial spasm (hemifacial spasm or myokymia) presents as
twitching of the eye, cheek and mouth and can be very debilitating.
- Spasmodic torticollis presents with twisting, turning,
and pain in the neck muscles. Often the head will pull vigorously
to one side.
- Writers cramp, along with associated local cramping, is
also a manifestation of an overuse syndrome.
- Post-stroke dystonia presents usually in the arm, with
severe muscular tightness and pain.
Treatment Available
- Older forms of treatment include anticholinergic agents
such as trihexyphenidyl and Cogentin.
- Muscle relaxants such as Baclofen, Dantrolene, and tizanidine
can all be helpful.
- Some anti-seizure drugs such as Tegretol have been used
and may be very effective.
- The most effective treatment is botulinum toxin, which
is delivered by a series of injections into the muscles.
Research
- Exploring the underlying cause of dystonia.
- New forms of botulinum toxin, with the goal of finding
more lasting treatments or treatments delivered by non-injection
route.
- Medical treatments.
- Possible use of deep-brain stimulators.
Website: Dystonia
Foundation; also National
Spasmodic Torticollis Association
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