DYSTONIA

TYPES

• Focal dystonia – affects one part of your body
• Segmental dystonia – affects two or more adjoining parts of the body.
• General – all parts of your body are affected. 

SYMPTOMS

Dystonia affects various people in different ways.

Muscle spasms might:

• Occur during a specific action, such as writing.
• Worsen with stress, fatigue, or anxiety.
• It becomes more noticeable and worsens over time if left untreated.
• It begins in a certain area, such as your neck, arm, or leg. Some patients have focal dystonia starting at the age of 21. Usually, their spasms start in the neck, arm, or face and tend to remain focal or segmental.

DIAGNOSIS

Your doctor will begin with a medical history and a physical examination to identify the type of dystonia, and might prescribe the following tests to determine the underlying problems or condition that causes the symptoms:

• Genetic testing
• MRI or CT scan
• Electromyography (EMG)
• Blood or urine tests

TREATMENT

Your doctor might prescribe a combination of therapy, medication, or surgery to treat your muscle spasms.

Your doctor might suggest the following therapies:

• Speech therapy if dystonia affects your voice
• Stretching or massage to ease muscle pain
• Occupational therapy or physical therapy, and sometimes both help ease spasms and improve function

• Injections into a particular muscle with botulinum toxin (Botox, Dysport, others) could decrease or remove your muscle spasms and strengthen your irregular postures. Usually, injections are taken every three to four months
• Generally, side effects are moderate and temporary. They may include fatigue, changes in voice, or dry mouth
• Some drugs target chemicals (neurotransmitters) in your brain that regulate muscle activity

In severe cases, your doctor might recommend the following surgeries:

• Selective denervation surgery 
• Deep brain stimulation