Dystonia is characterized by intermittent or prolonged involuntary muscle contractions in one or more parts of the body that result in long-term “abnormal” body postures. The symptoms of this disease can be alleviated by different treatments and the prognosis of the patients remains favourable in most cases. No cognitive or intellectual impairment is generally associated with abnormal movements, but motor disability can cause psychological suffering and often leads to social adjustment difficulties or anxiety disorders.
Symptoms of Dystonia
Abnormal muscle contractions can reach one or more parts of the body.
When dystonia affects only one or two adjacent parts of the body, it is called focal or segmental dystonia. They are the most common type of dystonia. The average age of onset of these forms of dystonia is 20 years.
In the early stages of the disease, contractions or spasms may be intermittent or may occur only under stress. The spasms can occur in the first stage only during movements. During the course of the disease, the contractions appear even at rest and cause deformation of the part of the body concerned, leading to pain and severe handicap.
Some contractions may be triggered by certain spots, called spot-specific dystonia or functional dystonia. The most common type of dystonia is cervical dystonia, which affects the neck muscles. Sacky contractions may result in torticollis, lateroparcels, anterocollis, or retroparcels.
The most common dystonia of function is in the hand and arm. It is also called writer’s cramp (hand) or musician’s dystonia (fingers or mouth) or golfer’s cramp (wrist) and is often due to misuse of the part of the body concerned.
Some patients may have spasmodic dysphonia due to vocal cord spasms making speech difficult, trembling jerky and voice hoarse or broken.
Dystopia may also affect the eyelids, leading to repeated, involuntary blinking at the onset of the disease and complete closure of the eyelids or blepharospasm. Patients with dystonia need to bailer, sing or open their mouths to keep their eyes open.
MEIGE syndrome is a segmental dystonia that affects both the jaw and the eyelids. Patients experience repeated blinking and characteristic grimacing due to clenching of the jaw and teeth. This form of dystonia usually begins around the age of 50.
More severe and widespread forms of dystonia affect many parts of the body or even all four limbs, preventing walking and hand use. They occur most often in children and adolescents.
Primary generalized dystonia is often manifested in childhood by a twisting of the foot inward (varus) and flexion of the foot arch during walking. This dystonia can reach the whole body during evolution and result in joint deformities preventing certain movements or even movements.
Doga-sensitive dystonia usually affects one leg in the first stage, causing the child to walk on the tip of the feet. The worsening of dystonia symptoms during the night and at rest is characteristic of dystonia, and some children suffer only muscle cramps after exercise.