Dystonia
Surgery for Dystonia
Surgery is reserved for severe cases that do not respond to medication. The surgical techniques used are intended to destroy these abnormal brain circuits that are keeping unwanted muscle spasms.
Pallidotomy is the heat-injury of the globus pallidus. The operation is performed under local anesthesia and the patient’s head placed in a device called a stereotactic frame to pinpoint the globus pallidus. When performed by a team of experts, the operation is safe and usually have few side effects. Most patients experience a marked improvement after the operation.
Instead of destroying the globus pallidus, you can stimulate through a deep brain stimulator, which is also a safe technique with minimal adverse effects. Can improve up to 65% of patients.
Other operations such as thalamotomy, which destroy parts of the thalamus, have been used in advanced generalized dystonias. Read the rest of this entry »
Dystonia: Diagnosis and Treatment
How is dystonia diagnosed?
There is no definitive test to diagnose specific dystonia. The diagnosis must be made by characteristic clinical signs and symptoms, the neurologist noted during the examination. You may also do some blood tests or any evidence of brain imaging (CT, MRI or PET) to see if any other disease or brain injury that are causing the dystonia. If there is any cause is called idiopathic dystonia.
Is there a cure for dystonia?
At present there is no cure for dystonia. However, it has a number of treatments that can significantly improve their symptoms.
What treatments are available?
Not all people with dystonia respond to the same medications, or the same doses. Finding the right drug and dose for a particular patient, may take time and patience is needed and change if they fail to take effect. Read the rest of this entry »
What Drugs Can Cause Dystonia?
What drugs can cause dystonia?
Certain drugs can cause dystonia, dystonia or worsen an existing one, so patients should be avoided if possible take them. Some of them are:
- Antidepressants: amitriptyline, clomipramine, fluoxetine, imipramine, nortriptyline, protriptyline, and so on.
- Anxiolytics are used to treat syndromes of anxiety (alprazolam, buspirone).
- Anti-nausea drugs and antiemetics: metoclopramide, thiethylperazine, etc.
- Neuroleptics: are used to treat psychosis and other movement disorders: chlorpromazine, fluphenazine, haloperidol, loxapine, mesoridazine, molindeno, perphenazine, thiothixene, triflupromazina, thioridazine, trifluoperazine, and so on.
- Other: lithium (treatment of bipolar disorder), midazolam (anesthetic), phenytoin (antiepileptic), promethazine (allergy), verapamil (antihypertensive). Read the rest of this entry »
Main Types of Dystonia: Secondary Dystonia
Secondary dystonia are those in which a cause is identified, or dystonia is caused by an environmental factor, or part of another neurological disease.
Environmental causes include head injuries, strokes, tumors, multiple sclerosis, brain infections, trauma to the spinal cord or peripheral nerve, drugs or toxins that damage the basal ganglia, thalamus or brainstem.
Other neurological disorders in which dystonia may occur include: Huntington’s disease, Parkinson’s disease, Wilson’s disease, ataxia teleangiectasia, Lesch-Nyham, Niemann-Pick disease and Leigh. All these causes of secondary dystonia are rare. Read the rest of this entry »
Main Types of Dystonia: Primary Dystonia
1. Generalized dystonia
Also known as primary dystonia or dystonia musculorum torque deformans. It usually occurs between 5 and 16 years. Usually starts in one part of the body, usually the foot. Involuntary muscle contractions quickly spread to affect all members and trunk. The disease usually progresses more slowly after adolescence.
2. Focal dystonia
Spasmodic torticollis, spasmodic torticollis or cervical dystonia is one of the most common focal dystonia (there are about 11 cases per million in Spain) and prevails in women. It usually occurs around age 40. Affects the muscles of the neck, causing uncontrollable or money abnormal postures of the head. Muscle spasms can be very painful.
Torticollis develops gradually, and may progress to the neck to remain permanently in an abnormal posture. Symptoms usually stabilize after five years. Rarely, the symptoms disappear spontaneously, but may reappear. Read the rest of this entry »
Dystonia
What is dystonia?
Dystonia is a syndrome characterized by involuntary muscle spasms, often painful, causing repetitive movements or abnormal postures held. Dystonia can affect a body part (focal dystonia) or the entire body (generalized dystonia).
What is the risk of dystonia?
It is estimated that in Spain there are about 300 cases of focal dystonia per million inhabitants. The number of cases of generalized dystonia is much lower (about 34 million inhabitants). Given how difficult it is to diagnose this disease, the number of people affected is probably higher.
Dystonia affects both men and women, but tends to predominate in women. The most common age of onset is 40 to 60 years, but can occur at any age.
Why dystonia occurs?
Dystonia is a movement disorder. It is still unknown exactly why it occurs, but is thought to be due to a disturbance in the functioning of deep brain structures, called basal ganglia, particularly in a part called the globus pallidus. The globus pallidus in turn controls to another structure called the thalamus, which is involved in the planning and execution of voluntary and involuntary movements. As a result of a malfunction, muscle contraction is not regulated properly, the wrong muscles contract or the muscles contract all at once, causing movements or abnormal postures. Read the rest of this entry »