Dystonia is a disorder in which the brain sends signals to certain muscles and causes them to contract involuntarily. A single group of muscles can be affected, or a large area of the body. About one person in 900 will have dystonia. Rarely it is hereditary, although not all members of a family will necessarily have symptoms. Medications, brain lesions or repetitive motions also can trigger dystonia, but most often the cause is unknown.
Dystonia is characterized by cramping, twisting, or a waving motion of the affected area. In an adult, the most common body regions are the eyes, lower face, neck, and arms. Dystonia that begins in childhood or adolescence may start in the leg and typically has a genetic cause. The movements can be quite painful because the muscles cannot be relaxed voluntarily. Individuals who are diagnosed with dystonia often experience extreme muscle fatigue that results from the constant contraction of the muscles. Stress may aggravate the symptoms, although stress is not the cause. A high proportion of people with dystonia have depression or other psychiatric disorders; however, it is essential to understand that this condition usually is not psychogenic or “all in your head.”
Botox® can be effective in slightly weakening the overactive muscle. By reducing the involuntary movements the person can exert more normal control over the body part. (See section on Botox®.) Certain medications that act on the central nervous system may be used to control involuntary contractions. Physical activity and exercise will not make the dystonia worse or better, so people with dystonia should exercise for their general health and well-being. Some people can learn to use self-distraction techniques, which will not eliminate the dystonia but may allow more normal function in social settings. As with Parkinson’s disease and tremor, deep brain stimulation may be considered for patients who experience severe symptoms and have a reduced quality of life.
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