How To Treat Dystonia

Dystonia is a movement disorder that causes twisting and jerking muscle spasms. The involuntary movements cause abnormal body postures and painful contortions. Dystonia is a rare disease, affecting only one percent of the entire population. The exact cause of dystonia remains unknown, but research suggests the problem arises from a malfunction in the brain's basal ganglia.

Genetics, other medical influences, drug reactions, a stroke, or tumor can also cause cases of dystonia. The types of dystonia and severity of the condition vary from mild to severe. Some individuals only experience localized dystonia in one muscle, while others have little control over their whole bodies.

Deep Brain Stimulation

As a surgical option, deep brain stimulation for dystonia works by placing a battery-generated simulator into the brain and using it to send electric pulses to targeted areas. Electrical stimulation through deep brain stimulation is used to treat a variety of neurological disorders. Doctors suspect the increased stimulation reduces excessive nerve impulses and signals, which cuts down the tremors, twisting, and muscle spasms in dystonia patients.

During deep brain stimulation surgery, adult patients are usually awake for a portion of the surgery, responding to questionings and following commands from surgical staff. Outpatient surgery is required to replace the simulators over a period, and it can take weeks to months for patients to begin experiencing the full benefits of the stimulation.

Physical Therapy

Physical therapy is a non-invasive treatment option for thousands of conditions including dystonia. While physical therapy can't treat the cause of dystonia, it can help patients regain some balance, coordination, range and better posture. Motor control can also be improved by working with a physical therapist; patients can learn how to recognize any physical habits that may have developed as a result of their dystonia and learn better methods to alleviate chronic pain and improve mobility. Physical therapists can also teach patients with dystonia to regain a semblance of control in their lives by teaching them how to adapt their bodies to perform routine tasks and activities such as writing, dressing, and eating.

Speech Therapy

Patients with spasmodic dysphonia/laryngeal dystonia and oromandibular dystonia may have difficulty speaking as the conditions affect the muscles in the mouth and tongue. Individuals who have lost the ability to communicate effectively can learn to regain control over their vocal cords and speak more clearly.

Voice and speech therapy may also be able to help patients whose dystonia affects their ability to swallow. In addition, speech therapy can help patients who have become shy and uncomfortable with others as a result of their condition learn to communicate more effectively, pursue a healthy social life and develop new relationships.

Stress Management

Relaxation techniques can help patients reduce stress, loosen muscles, and relieve tension that can worsen spasms and muscle contractions. Through a variety of practices such as deep breathing, visualization, learning to relax the body and redirecting thoughts can help reduce stress levels. One popular form of stress management for dystonia patients is the Relaxation Response developed by Dr. Herbert Benson. The practice promotes body awareness, muscle recognition, relaxation, and deep breathing techniques.

Speaking to a therapist can greatly benefit patients living with dystonia and other chronic conditions. Dystonia can lower self-esteem and impact individuals socially due to its awkward posture and abnormal, uncontrollable spasms. A clinical psychologist can help patients manage their stress to help reduce symptoms as well as become more confident despite their condition.

Biofeedback

Biofeedback therapy trains individuals to gain control over involuntary bodily functions. Doctors aren't sure why this type of therapy works so well, but it's proven time and time again to manage many different health problems and conditions such as migraines, irritable bowel syndrome, incontinence, attention deficit hyperactivity disorder, anxiety disorders, and chronic pain.

There are several types of biofeedback, and a movement disorder specialist and neurologist can discuss what types are best for a patient with dystonia. During a session, a therapist attaches electrodes to the patient's skin and helps them identify their body's reaction to a spasm. Guided techniques like deep breathing, mindfulness meditation, and progressive muscle relaxation can help patients decrease the severity of their symptoms.

Botox Injections

Botulinum toxin (Botox) is a protein the bacterium Clostridium botulinum produces that is neurotoxic to human tissues. Individuals affected by dystonia may be able to treat their symptoms using botox injections. An individual affected by dystonia has muscles that contract uncontrollably and involuntarily. These movements can affect a single muscle, a localized muscle group, or it can be systemic or affect all or most of the muscles in the individual's body. Botox works to treat these movements by attaching to the end of the nerve, where a muscle and nerve join together.

It stops a chemical called acetylcholine from being released by the nerve into the muscle. Without the release of acetylcholine, the muscle cannot contract. Botox is delivered to the affected individual by an injection into the muscle affected by dystonia to alleviate the debilitating symptoms it is causing. The effect of botox injections is permanent for between two and three months following the injection until the individual's body forms new synaptic contacts in the area of the injection.

Medications That Target Certain Neurotransmitters

Dystonia patients may need to take medications that work to treat the disorder by targeting certain neurotransmitters. Neurotransmitters are chemicals that allow a nerve impulse to jump from one nerve to the next nerve or junction. Certain medications involving neurotransmitters can calm the impulses that cause the affected muscles to excessively contract in dystonia patients. These medications typically target gamma-aminobutyric acid, dopamine, and acetylcholine neurotransmitters. Some of these medications called benzodiazepines work by raising the levels of gamma-aminobutyric acid in the individual, which causes excessive muscle relaxation.

Other medications called anticholinergics work to treat dystonia by inhibiting acetylcholine release into the muscles, effectively inhibiting the neurotransmitter from triggering muscle contractions. A medication called levodopa works by increasing the levels of dopamine in individuals affected by a form of dystonia caused by a malfunction in the production of dopamine by the brain. Baclofen is a muscle relaxant medication utilized to treat specific individuals who have dystonia caused by an injury or trauma to their central nervous system.

Stretching Or Massage

Individuals affected by the focal variation of dystonia may be able to manage their symptoms with the use of stretching or massage. Focal dystonia is limited to a specific group of muscles in the body. Focal dystonia commonly causes problems with muscle movement in the patient's neck, mouth, jaw, hands, eye, tongue, or voice. Several massage methods, including deep tissue therapy and myofascial release, can be helpful for tissues around the muscle that have become tight and stiff.

Massage also helps an affected individual with the aspect of not just physical, but also mental relaxation. Dystonia can cause a patient's muscles to become fatigued quickly from unintentional muscle overuse. To counteract the muscle fatigue that occurs in dystonia patients, stretches along with other exercises can be utilized to help strengthen the affected muscles. Joint soreness that has resulted from dystonia due to deterioration of joint components can also be alleviated with the use of stretching exercises and massage.

Selective Denervation Surgery

When an individual's cervical dystonia does not respond to other methods of dystonia treatment, selective denervation surgery may be considered. Selective denervation surgery works by disrupting the nerve impulse pathways causing a patient's abnormal movements. One of several mechanisms can be used to sever specific nerves close to the spinal cord that channel to the nerve roots located deep in the patient's neck. Another mechanism of selective denervation surgery involves the careful selection of certain nerves to be removed at the junction where they enter into the muscles affected by the abnormal contractions.

The surgeon uses electromyography technology to direct and help them identify the muscles involved in the individual's dystonia during selective denervation surgeries. This type of surgery has shown to be successful at treating some symptoms of dystonia that affect an individual's neck muscles, but only highly specialized institutions offer the procedure. A small number of cervical dystonia patients are eligible for the procedure, and extensive physical therapy is required following the denervation surgery.

Yoga

Some forms of yoga can be helpful to individuals living with dystonia. Yoga is a type of meditation and exercise blend that focuses on flexibility, strength, and balance. It is beneficial for an individual to increase the flexibility of the muscles being affected by abnormal contractions because it helps manage pain and promotes muscle relaxation. Muscles may also become shortened due to tension caused by dystonia. Yoga can help loosen and lengthen the affected muscles so the individual can regain a healthy posture. The muscle movements that occur in dystonia can cause a patient's body to become off-centered.

Yoga helps with strengthening the muscles responsible for supporting an individuals alignment of lateral and upright posture. Yoga also helps dystonia patients regain their balance if they have lost it as a result of their condition. Yoga also guides an individual through meditation, which can be helpful to those frequently stressed because of their dystonia.