Characteristic involuntary contractions of muscle that result in slow repetitive movement or abnormal posture is called dystonia.
These involuntary movements may cause pain and some individuals may experience tremor or neurological symptoms.
Dystonia may affect only one muscle, group of muscles or muscles of whole body.
It is a progressive disorder, initially it causes mild symptoms but at later stages food swallowing becomes difficult.
Causes of Dystonia
• Idiopathic: exact cause is unknown
• Altered communication between nerve cells that is located in the basal ganglia (an area of the brain that is involved in initiating contractions of muscles).
• It may be an inherited condition.
• It may develop in some individuals who perform high precision hand movements.
• Neuroleptic drugs may cause this disease.
• Generalized dystonia
• Cervical dystonia
• Laryngeal dystonia
• Oromandibular dystonia
• Hemifacial spasm
• Writer’s cramp
• Myoclonus dystonia
• Paroxysmal dystonia
The symptoms start in one limb and then spread to other parts of the body.
Symptoms of generalized dystonia are:
• Spasms of muscle occur.
• The extremity takes an abnormal, twisted posture.
• A foot, leg or arm turns inwards.
• Body parts jerk rapidly.
Cervical dystonia is also called torticollis. It is the common form of dystonia.
Symptoms of cervical dystonia are:
• Neck muscles contract.
• Sensation as if patient is being pulled forwards, backwards or from side to side.
Blepharospasm affects the muscles around eyes.
Symptoms of blepharospasm are:
• Irritation in eyes.
• Sensitivity to light.
• Uncontrolled blinking of eyes.
• Uncontrollable closing of the eyes.
Muscles of one side of the face undergo spasm in hemifacial spam. This symptom aggravates when patient is feeling tired or under stress.
Spasm of the muscles of the larynx occurs in laryngeal dystonia. Voice sounds either ‘strangled’ or quiet or ‘breathy’ depending on whether spasm occurs outwards or inwards.
Involuntary movement and cramps in the muscles of the arm and wrist is called writer’s cramp. People who are involved in lot of writing are affected.
Writer’s cramp is of two types – simple and dystonic.
Simple Writer’s Cramp:
People who suffer from simple writer’s cramp experience difficulty with only one specific task e.g. when the individual starts writing, after writing a few words spasm begins and diminishes the speed and accuracy of writing.
Dystonic Writer’s Cramp:
This type of spasm occurs while writing and also while performing other tasks with hand.
It affects the muscles in the arms, neck and torso. It is a rare type of dystonia. Sudden jerk like spam similar to electric shock are caused by myoclonus dystonia.
Muscles of mouth and jaw are affected in oromandibular dystonia. Mouth is pulled upwards and outwards, swallowing becomes difficult and in some cases symptoms appears while eating and talking.
It is a rare type of dystonia in which spasms of muscle and unusual body movements appear at certain times. The symptoms mimic an epileptic fit. But unlike epilepsy patient does not lose consciousness and remains aware of the surroundings.
Attack remains for few minutes to several hours. Stress, fatigue, coffee, alcohol or sudden movements may trigger an attack.
• CT scan
• Blood and urine test
• Medicines: Levodopa, Botulinum toxin, Anticholinergics, Muscle relaxants.
• Physical therapy: physiotherapy to the affected part is effective.
• Surgery: if medicines and physiotherapy fail surgery is recommended.
With prompt treatment, the impact of symptoms can be minimized and person’s ability to perform everyday activities can be improved.
Depending on the type of dystonia, complications are:
• Permanent physical deformity.
• Vitamin D, E, B
• Eat lots of fruits.
• Consume less meat.
• Muscles of the face jerk and twitch.
• Eyelids and mouth open and close in rapid succession.
• Unsteady gait.
• Legs in motion while sitting, and dragged while attempting to walk.
• Twitching of the eyelids.
• Spasmodic movements, from simple involuntary motions and jerks of single muscles to a dancing of the whole body.
• Trembling of the limbs.
• Involuntary movements cease while asleep.
• Symptoms worse during a thunderstorm.
• Choreic movements in the night.
• Movements involve the right side of the body more than they do the left.
• The muscles of the tongue are affected so that the speech is thick, and the words have to be jerked out.
• There is a marked paretic condition of the affected parts.
• The twitching, which is mostly local or confined to certain parts, as the face, the eyelids, the arm.
• Disposed to laugh and be talkative.
• Worse after eating.
• Choreic movements involve right arm and left leg.
• Head drawn downward.
• Involuntary discharge of urine.
• Patient can run well than walk.
• Trembling of the body movements continue even at night but subside under the influence of music.
• Trembling and jerking movements of all the limbs, rendering her unable to feed her or to walk.
• Frequent, clear, profuse micturition.
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