What Is Dystonia?
Dystonia occurs when brain circuits that control movement send abnormal signals to muscles, causing them to contract involuntarily.
These contractions may be:
- Sustained or intermittent
- Painful or painless
- Mild or severe
- Limited to one body part or involve multiple regions
Dystonia can affect both children and adults.
Recognising the Symptoms of Dystonia
What does dystonia look and feel like?
Dystonia does not look the same in every patient. The symptoms depend on which muscles and parts of the nervous system are involved.
Common symptoms of dystonia include:
Involuntary twisting movements
A body part may repeatedly twist, turn, or move into an abnormal position without the person intending it.
Abnormal postures
The neck, hand, arm, leg, foot, or other body part may be pulled into an unusual position because of involuntary muscle contractions.
Repetitive movements
Some patients experience recurring movements that become more noticeable during particular activities.
Muscle spasms
Dystonia can cause sustained or intermittent muscle contractions. These spasms may sometimes be uncomfortable or painful.
Tremor
Some people with dystonia develop a tremor. A dystonic tremor may have characteristics that differ from the tremor seen in other movement disorders.
Task-specific symptoms
In some forms of dystonia, symptoms appear predominantly during a particular activity. Examples include hand dystonia while writing or performing a specific skilled movement.
Pain and muscle fatigue
Persistent abnormal muscle contractions can place considerable strain on affected muscles and may lead to pain, discomfort, or fatigue.
Sensory tricks
Some patients discover that a very simple sensory stimulus—such as lightly touching a particular part of the body—temporarily improves their abnormal posture or movement. This phenomenon is known as a sensory trick and can be a useful clinical clue.
Types of Dystonia
Cervical dystonia
Cervical dystonia affects the muscles of the neck and can cause involuntary turning, tilting, or pulling of the head and neck. It is one of the more common forms of adult-onset focal dystonia.
Cranial and facial dystonia
Cranial dystonia affects muscles of the face and head. It may cause involuntary facial movements or abnormal contractions around the eyes.
Oromandibular dystonia
This form affects the muscles involved in movements of the jaw, mouth, and tongue. Patients may experience involuntary jaw movements, difficulty opening or closing the mouth, or abnormal tongue movements.
Limb dystonia
Dystonia affecting an arm, hand, leg, or foot may interfere with walking, writing, playing an instrument, or other activities requiring precise movements.
Task-specific dystonia
Symptoms occur predominantly during a particular activity. Examples include writer's cramp and certain forms of musician's dystonia.
Segmental dystonia
Two or more neighboring regions of the body may be affected, such as the neck and face.
Generalized dystonia
Generalized dystonia affects multiple regions of the body and may cause widespread abnormal movements and postures.
Primary and secondary dystonia
Dystonia may also be classified according to its cause. Primary dystonia occurs without another identifiable neurological disorder being responsible for the symptoms, while secondary dystonia can occur as a result of another condition, medication, brain injury, stroke, or other causes.
Because different forms of dystonia can respond differently to treatment, identifying the specific type is an important part of specialist assessment.
