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 crampFocal dystonia can be treated. If you suspect you have this condition, contact your doctor.
Dystonias are caused by flaws of the basal ganglia of the brain. This is where messages that begin muscle contractions are processed. Factors that may cause focal dystonia include:
Birth injury, such as lack of oxygenInfectionReactions to medicinesHeavy metal poisoningCarbon monoxide poisoningTraumaStrokeInherited abnormalitiesVitamin B12 deficiencyOther diseasesFactors that can increase your risk of developing focal dystonia include:
Family history of dystoniaRecent exposure to an antinausea or antipsychotic medicineIf you have any of these symptoms, do not assume it is due to focal dystonia. These symptoms may be caused by other conditions:
Eyelid spasmsRapid or uncontrollable blinking of both eyesNeck twistingDifficulty writingFoot crampsPulling or dragging of a footTremorVoice or speech difficultiesFactors that may worsen dystonia include:
Excitement or agitationStressTalkingFatigueYour doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a speech-language pathologist, physical or occupational therapists, and/or genetic counselors.
Tests may include:
Your bodily fluids and tissue may need to be tested. This can be done with:
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
Other exams may include:
Neurologic evaluation—to rule out other neurological disordersEye examTalk with your doctor about the best treatment plan for you. Treatment options include the following:
Certain medicines may help correct imbalances in neurotransmitters. Medicines used to treat dystonia include:
TrihexyphenidylBenztropineProcyclidine HClMuscle relaxantsLevodopa and carbidopaBromocriptineAnticonvulsant medicines may also help people with dystonia. Your doctor will balance treating your symptoms with reducing the risk of side effects from the medicines.
Injecting
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. More recently, some success has been reported using surgically implanted deep brain stimulation to reduce symptoms of dystonia.
There is no known way of preventing focal dystonia. To help reduce your chances of getting this condition, take steps to reduce your risk of infection, stroke, trauma, and
carbon monoxide
or heavy metal poisoning. In addition, if you take any of the following medicines, talk with your doctor about your risk of developing dystonia as a side effect:
LevodopaBromocriptineAntipsychoticsMetoclopramideDilantinCalcium channel blockersSelective serotonin reuptake inhibitorsErgotaminesAntihistaminesLast reviewed March 2013 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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