“A river cuts through rock, not because of its power, but because of its persistence.”
– James N. Watkins

Dystonia

Dystonia is a movement disorder in which a person has uncontrollable muscles contractions. The contractions are sustained and cause the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. The movements, which are involuntary and sometimes painful, may affect a single muscle; a group of muscles such as those in the arms, legs, or neck; or the entire body.

 

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Dystonia

 

Symptoms of Dystonia

Dystonia can occur at any age, but is often described as either early, or childhood, onset versus adult onset. Early symptoms may include deterioration in handwriting, foot cramps, or a dragging foot after running or walking some distance. Other possible symptoms are tremor and voice or speech difficulties. Adult onset usually begins in the neck and/or face and often progress from intermittent to more frequent or fixed postures.

 

Sometimes, the neck may turn or pull involuntarily, especially when the person is tired or under stress. Sometimes both eyes might blink rapidly and uncontrollably; other times, spasms will cause the eyes to close. Symptoms may also include tremor or difficulties speaking.


Causes of Dystonia

Most cases of dystonia do not have a specific cause identified. In some cases, dystonia may be related to a problem in the area of the brain that is responsible for initiating muscle contractions, the basal ganglia and are a result of a stroke, trauma or infection..


Treatment of Dystonia:

Currently, there are no medications to prevent dystonia or slow its progression. There are, however, several treatment options that can reduce the symptoms of dystonia,.

Botulinum toxin

Botulinum injections often are the most effective treatment for the focal dystonias. Injections of small amounts of this chemical into affected muscles prevents muscle contractions and can provide temporary improvement in the abnormal postures and movements that characterize dystonia.

Anticholinergic agents

Anticholinergic agents block the effects of the neurotransmitter acetylcholine.  Sometimes these medications can be sedating or cause difficulties with memory, especially at higher dosages and in older individuals which can limit their usefulness. Other side effects include dry mouth and constipation.

GABAergic agents

GABAergic agents are drugs that regulate the neurotransmitter GABA. These medications include baclofen and the benzodiazepines such as diazepam, lorazepam and clonazepam. Drowsiness is a common side effect.

Dopaminergic agents

Dopaminergic agents act on the dopamine system and the neurotransmitter dopamine, which helps control muscle movement. Some people benefit from drugs that block the effects of dopamine, such as tetrabenazine but side effects (such as weight gain and involuntary and repetitive muscle movements) can limit their usefulness.


References

 

Dystonia – Overviews

  1. dystonia-get-the-facts-on-the-syndrome-and-treatment
  2. dystonias-information-page-national-institute-of-neurological-disorders-and-stroke
  3. dystonia-causes-types-symptoms-and-treatments-webmd

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