Dystonia

Reviewed by: HU Medical Review Board | Last reviewed: October 2022 | Last updated: December 2022

Dystonia is a movement disorder where muscles contract involuntarily. It can cause twisting of limbs, repetitive movements, or abnormal postures. Dystonia is often seen in people with Parkinson's disease (PD) and can be quite disabling.1,2

There is no cure for dystonia. But treatments can help lessen its symptoms. If you are experiencing dystonia, it is essential to discuss your options with your doctor.1,2

What causes dystonia in PD?

The exact cause of dystonia in people with PD is not known. However, it is thought to be related to the loss of dopamine-producing cells in the brain. Dopamine is a chemical messenger (neurotransmitter) that helps to control movement. When there is not enough dopamine, muscles can contract involuntarily.3

The basal ganglia are a group of nerve cells (neurons) located in the brain. These cells help with movement. They help us plan how to do things like catch a ball or write with a pen. The basal ganglia work with the outer portion of the brain (cortex) to send messages to and activate muscles. When you have PD, the neurons that use dopamine in the basal ganglia are damaged, leading to dystonia.4

How dystonia appears

The symptoms of dystonia in Parkinson's disease can vary from person to person. They may include:1-4

  • Twisting movements
  • Repetitive movements
  • Abnormal postures
  • Pain
  • Difficulty moving
  • Foot cramps or dragging your feet
  • Tremor
  • Handwriting that gets worse after you write several lines
  • Problems speaking
  • Rapid eye blinking or spasms

Diagnosis

Diagnosing dystonia in Parkinson's disease can be difficult. That is because dystonia can occur along with the other symptoms of PD. Your doctor will likely perform a physical exam and order some tests to help make a diagnosis. These tests may include:1,4

  • Blood work
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan

Types of dystonia

There are several types of dystonia, depending on the area of the body affected. These include:1

  • Generalized dystonia affects most of the whole body in some cases.
  • Focal dystonia affects a specific region or part of the body.
  • Multifocal dystonia affects 2 or more unrelated body parts.
  • Segmental dystonia affects 2 or more body parts close to each other.
  • Hemidystonia affects the arm and leg on the same side of the body.

The most common forms of focal dystonia include:1

  • Cervical (torticollis) impacts the muscles of the neck.
  • Blepharospasm affects the muscles of the eye.
  • Cranial affects the muscles of the head, face, and neck and could include the eyes.
  • Task-specific, which only occurs during specific repetitive tasks. “Writer’s cramp” – when writing for an extended time causes cramping in the hand and forearm – is one example.

Treatment

Like PD, dystonia has no cure. However, some treatments can help lessen its symptoms. These include:1-4

If you are experiencing dystonia, it is crucial to get help. Talk to your doctor about your options, and seek treatment as soon as possible. With the proper treatment, you can manage your symptoms and live a full life.

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