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What is dystonia?

Dystonia is an involuntary muscle contraction that can cause abnormal and painful twisting movements or distorted posture. Dystonia may affect a single muscle, a group of muscles, or even the whole body. Around 70,000 people in the UK are thought to be living with dystonia.

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What causes dystonia?

The exact cause of dystonia is unknown, but scientists believe it may be related to damage in regions of the brain that control movement, such as the basal ganglia. There may also be disturbances in how the brain processes information and in the way different brain cells communicate with each other via neurotransmitters (chemical messengers, produced by brain and nerve cells). Dystonia can be classified into three groups depending on the cause:

Genetic: Dystonia can be inherited and there are currently 13 genes known to be associated with the condition.

Acquired dystonia: Sometimes dystonia is caused by exposure to medications, infections or a brain injury. It can also be a result of another medical condition such as Parkinson’s disease or stroke. In children, cerebral palsy is the most common cause, resulting from a problem with the brain that occurs around birth.

Idiopathic dystonia: This is the term used when there is no clear cause found.

 

What are the symptoms of dystonia?

Symptoms vary according to part of the body affected and the number of muscles involved. It may cause abnormal eye blinking, or can affect the wrist and hand, causing problems with writing. Dystonia in the neck may cause the head to become pulled in one direction or result in difficulty turning the head. If it affects the voice box, it can cause problems with speech. Symptoms may become more noticeable with tiredness or stress.

When dystonia develops in adults, it usually affects the same area without spreading. This is known as ‘focal’ dystonia. In children, however, it may spread to other parts of the body and become a more generalised dystonia.

How is dystonia diagnosed?

Our leading specialist doctors here at The London Clinic Centre for Movement Disorders are experts in the diagnosis and management of dystonia.

They will begin by asking questions about the symptoms, such as when the problem started, which part of the body is affected and whether there are any family members with similar symptoms.

A careful assessment of function and movement is carried out to understand the type of dystonia. The diagnosis is often based on this clinical information, but additional MRI scans of the brain, blood tests and urine samples may also be needed.

What are the common treatments for dystonia?

Unfortunately, dystonia cannot be cured or prevented. However, there are a number of treatments that our multidisciplinary team of specialists can offer to help relieve the symp­toms and restore function:

Botulinum toxin (Botox) injections

This involves injecting a small amount of chemical toxin directly into the affected muscle. It can help it to relax within a few days and can temporarily improve the symptoms. It is not a permanent solution, but the effects will normally last for several months.

Medications

There are a variety of medicines that target neurotransmitters to relieve symptoms. The response to a medication is variable and it can take time to find the correct dose.

Surgical procedures

These are generally associated with some risks, and so may only be considered when other treatments have failed.

Selective denervation surgery is an example of a surgical treatment that cuts the nerves that are causing the dystonia. This leads to a permanent relaxation of the muscle.

Deep brain stimulation is another surgical procedure, which can be offered if the symptoms are severe. It involves inserting tiny electrical wires (electrodes) into the region of the brain responsible for the dystonia. The electrodes are connected to a small electrical device that sits under the skin. A painless electrical impulse is delivered through the electrode to block the signals causing the dystonia.

Other surgeries that block faulty signals from the brain include thalamotomy and pallidotomy. They involve removing, or causing a precise destruction to, the area of the brain that causes the dystonia.

Physiotherapy

This is a key component of treatment. Here are the London Clinic, we have a comprehensive and experienced team of physiotherapists who can support the care of patients with dystonia. Exercise therapy can often be used to relieve pain and ease postural problems.

We also offer access to the following services within our range of physical therapies:

Other surgeries that block faulty signals from the brain include thalamotomy and pallidotomy. They involve removing, or causing a precise destruction to, the area of the brain that causes the dystonia.

Why choose The London Clinic?

At The London Clinic, we offer access to the latest technologies and are committed to delivering quality care with short timelines between diagnosis and treatment. We offer access to a full multidisciplinary team with leading expert specialists in the field of movement disorders, and clinical support teams that are second to none.

 

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