As one of several movement disorders, dystonia is a condition characterized by sustained, involuntary muscle contractions that can cause repetitive movements and abnormal postures.
There are two types of dystonia, including:
- Primary dystonia – This type of dystonia has genetic components, often running in families.
- Secondary dystonia – Also called acquired dystonia, this form of the condition results from a car accident, stroke, or cerebral palsy.
In general, dystonia produces varying degrees of mild to painful spasms, but often the symptoms depend on the part of the body affected. The National Institute of Neurological Disorders and Stroke classifies these common forms as:
- Cervical dystonia – This form of the condition affects the muscles in the neck, causing the head to contort or be pulled forward or backward.
- Blepharospasm – Uncontrollable eye spasms are caused by this form of dystonia and can lead to the eyelids closing completely.
- Craniofacial dystonia – The head, neck, and face are affected by this type of dystonia, making it difficult to swallow and communicate.
- Task-specific dystonia – Writing, playing an instrument, or typing can be difficult with this form of dystonia, as it causes spasms to occur when trying to perform a specific task.
Traditional Therapies for Dystonia
Unfortunately, there is no medication to prevent dystonia, but there are drugs that can help relieve its symptoms, especially if it is localized to one part of the body. These drugs either block or regulate the neurotransmitters responsible for the muscle spasms.
Other options include injections, such as botulinum toxin (botox), to the affected muscles. The botox also blocks the neurotransmitters responsible for the muscle contraction.
Muscle relaxants and tranquilizers have some effect and can work.
Deep Brain Stimulation for Dystonia
When dystonia becomes severely debilitating and a patient fails to respond to botox or pharmacologic treatment, deep brain stimulation (DBS) may be recommended.
DBS involves the implantation of a tiny electrode into the brain. From there, the electrode is programmed to block the signals to the brain responsible for the muscle contractions and other symptoms of dystonia. Since the electrode is always on, patients find that they have continued relief from their dystonic symptoms.
The Center for Neuromodulation’s multidisciplinary team of neurosurgeons, neurologists, neuropsychologists, geneticists, and eye movement specialists will work with patients to customize a treatment plan that includes precise programming of DBS to ensure promising results.
DBS works best on patients with primary dystonia, with up to 50 to 90 percent improvement of their symptoms. Our team can determine if the neurosurgical treatment is the best approach and can provide additional resources such as referrals to the Parkinson and Movement Disorders Center if better options exist.
For a comprehensive evaluation, call the Center for Neuromodulation at the Department of Neurosurgery at 212-241-0050.
Center for Neuromodulation
5 East 98th Street
New York, NY 10029