About Dystonia
Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both. Dystonic movements are typically patterned, twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation.
These characteristics may be the sole clinical manifestation, or occur as secondary symptoms due to other underlying disease processes, drug/toxin exposure or brain injury. Therefore, many different types of dystonia are recognized. Dystonia can develop at any age, although people with earlier onset dystonia are more likely to have a more severe course. Dystonia is one of the most common movement disorders, with an overall prevalence of approximately 16,5 cases per 100,000 .
The diagnosis is difficult to make, often delayed, and sometimes misled by several factors: variability of dystonia presentation, uncertain recognition of the specific physical signs, lack of diagnostic tests, wide etiological spectrum, and confounding with other movement disorders.
Therefore expert clinical examination is recommended for diagnosis, especially since proper classification is important for prognosis, genetic counseling, optimal treatment, and appropriate disease management.
There is no real cure for dystonia. Symptomatic treatment includes anticholinergic, antiepileptic and dopaminergic drugs. However, their effectiveness is uncertain for most forms of dystonia.
In many cases the treatment of choice consists of injection of the affected muscles with botulinum toxin.
Deep brain stimulation is considered a good option, particularly for primary, generalized or segmental dystonia after medication or botulinum toxin has failed to provide adequate improvement.
Also, physical therapy and rehabilitation have an important role in the care of patients with dystonia.