Guide To The Symptoms Of Dystonia
Dystonia is a condition that causes patients to experience unintentional muscle contractions that eventually result in postural abnormalities. Dystonia can be caused by brain injuries, heavy metal poisoning, and oxygen deprivation, and acute dystonia is a potential side effect of some types of antidepressants, antipsychotics, and antiemetics. Some patients with dystonia only experience involuntary muscle contractions in one part of the body; this is known as focal dystonia. Patients who experience symptoms in two or more adjacent body parts have what is known as segmental dystonia, and individuals affected across widespread areas of the body have general dystonia.
To diagnose dystonia, doctors take a medical history and perform a physical examination. Blood and urine tests might be recommended to check for underlying medical conditions that could be contributing to the patient's symptoms, and MRI and CT scans are useful in detecting potential abnormalities in the brain. Electromyography studies may be necessary to check the electrical activity within the patient's muscles. Injections of onabotulinumtoxinA can be administered into specific muscles to reduce or potentially eliminate a patient's abnormal muscle contractions, and these injections are typically given every three months. Patients may also be given medicines such as carbidopa-levodopa, trihexyphenidyl, or tetrabenazine. In cases of severe dystonia, deep brain stimulation might be considered.
Contractions In A Certain Area
Patients with focal or segmental dystonia may notice they tend to experience contractions in a certain area of the body. The neck, eyelids, jaw, tongue, vocal cords, hands, and forearms are common areas for these types of contractions. Contractions of the neck muscles can cause patients to twist or turn their head to one side, and they may sometimes cause their head to lean forward or backward.
In cases of eyelid muscle contractions, patients could notice dry eyes, and might have episodes of rapid blinking. While these contractions don't normally cause pain, patients could notice vision difficulties during the contractions, and they could have episodes more often when they are in bright light. Contractions of the jaw and tongue muscles may cause pain, and patients have reported drooling, slurred speech, and swallowing difficulties. When vocal cord muscles contract, individuals may only be able to speak at a whispering volume. Muscle contractions in the hands and forearms could result in dropping objects and difficulties typing or handwriting.
Contractions Triggered By Specific Actions
Patients with task-specific focal dystonia may have contractions triggered by specific actions. For example, these individuals might observe muscle contractions while trying to write, and contractions could also occur while playing a musical instrument. Generally, patients who have contractions triggered by specific actions do not experience contractions at other times. Individuals who experience contractions while writing may have writer's dystonia (writer's cramp). This form of task-specific focal dystonia could cause the patient to grip a pen with excessive force, and they might also elevate their shoulders, retract their arm, or occasionally extend their fingers while holding a pen or while typing.
Individuals with musician's dystonia typically do not experience any pain with their symptoms. The highest incidence of musician's dystonia is seen in pianists, guitarists, and brass players. Patients are normally affected in one hand, and brass players may experience symptoms in the hands or embouchure. Their fingers may curl up, and their thumb could flex involuntarily. Some individuals might also notice a tremor. Neurotoxin injections and occupational therapy are often beneficial in cases of task-specific focal dystonia.
