Focal dystonia is an irregular movement disorder specific to one part of the body. In dystonia, muscle contractions cause irregular movements, twitches, tics, and twisted or repetitive postures. These may be continuous or off and on.
The most common types of focal dystonia are: Blepharospasm—an eye twitchCervical dystonia or spasmodic torticollis—affecting the neckSegmental cranial dystonia, also known as Meige syndrome—affecting the jaw, tongue and eyesOromandibular dystonia—affecting the jawSpasmodic dysphonia—affecting the vocal cordsAxial dystonia—affecting the trunkDystonia of the hand/arm, such as writer's cramp
In many cases, the cause of primary dystonia is not known. In others, it may be genetic.
Secondary dystonia is caused by an existing health condition, injury, or genetic disorder. Some of these include: Birth injury, such as lack of oxygenInfectionReactions to medicationHeavy metal poisoningCarbon monoxide poisoningTraumaStrokeOther diseases
The Process of Carbon Monoxide Poisoning Decreasing Available Oxygen
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Family history increases your chance of developing primary dystonia.
Having a specific health condition, injury, or genetic disorder increases your chance of developing secondary dystonia.
Symptoms may include: Eyelid spasmsRapid or uncontrollable blinking of both eyesNeck twistingDifficulty writingFoot crampsPulling or dragging of a footTremorVoice or speech difficulties
Factors that may worsen dystonia include: Excitement or agitationStressTalkingFatigue
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
This may include a complete neurologic exam and an eye exam.
You may be referred to a speech-language pathologist, physical or occupational therapists, and/or genetic counselors.
Tests may include: Blood testsUrine testsGenetic testsLumbar punctureBiopsy
The electrical activity of your muscles, nerves, and brain may need to be measured. This can be done with: ElectromyographyNerve conduction studyElectroencephalography
Pictures may need to be taken of your head. This can be done with: MRI scanCT scanTranscranial ultrasound
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Talk with your doctor about the best treatment plan for you. Options include:
Your doctor may recommend one or more of the following to help ease symptoms: Over-the-counter or prescription pain relieversAnticholinergicsBenzodiazepinesDopaminergic agentsDopamine-depleting agentsAnticonvulsants
botulinum toxin directly into the muscles affected by dystonia can weaken the muscle. This may help improve symptoms for 3-4 months.
Surgery to cut the nerves leading to muscles affected by dystonia or removing the muscles may help reduce muscle contractions. In addition, surgery to destroy the small area within the brain that dystonia occurs from may stop or reduce the disorder. Some success has been reported using surgically implanted deep brain stimulation to reduce symptoms of dystonia.
There are no current guidelines to prevent focal dystonia. If you take any medications that may cause dystonia, talk with your doctor about your risk of developing dystonia as a side effect.
About dystonia. Dystonia Medical Research Foundation website. Available at:
http://www.dystonia-foundation.org/pages/what_is_dystonia_/26.php. Accessed July 11, 2013.
Cervical dystonia. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated August 29, 2012. Accessed July 11, 2013.
Dystonia. The Canadian Movement Disorder Group website. Available at:
http://www.cmdg.org/Movement_/dystonia/dystonia.htm. Accessed July 11, 2013.
Dystonias fact sheet. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm#221673257http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm#221673257. Updated July 2, 2013. Accessed July 11, 2013.
Gaenslen A. Transcranial sonography in dystonia.
Int Rev Neurobiol. 2010;90:179-87.
Meige Syndrome. National Organization for Rare Disorders. Available at:
http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Meige%20Syndrome. Accessed July 11, 2013.
NINDS dystonias information page. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/dystonias/dystonias.htm. Updated July 2, 2013. Accessed July 11, 2013.
Overview of dystonia. Worldwide Education and Awareness for Movement Disorders website. Available at:
http://www.wemove.org/dys/dys.html. Updated May 26, 2013. Accessed July 11, 2013.
Last reviewed May 2014 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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