Dystonia, Causes, Diagnosis, Treatment, Prevention, Complications

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Dystonia is a disorder that causes muscles to move on their own involuntarily. As a result of this muscle movement, people with dystonia have abnormal body postures and experience tremors. Dystonia can occur in one limb to the whole body. 

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Dystonia, Causes, Diagnosis, Treatment, Prevention, Complications


People with dystonia will make involuntary movements that are fast, jerky, or slow, sometimes even their movements resemble tremors. This movement occurs repeatedly and has the same pattern.

Dystonia or dystonia is a very rare disease. This condition is experienced by 1% of the world's population, with more women than men.

Causes of Dystonia


The cause of dystonia is still unknown. However, this condition is thought to be related to changes or disturbances in the brain's nerve cells.

Dystonia can also be caused by other diseases, such as:

  • Parkinson's disease
  • Huntington's disease
  • Wilson's disease
  • Brain injury from impact or accident
  • Brain injury in babies due to childbirth
  • Carbon monoxide or heavy metal poisoning
  • Brain tumor
  • Infections, such as encephalitis
  • Strokes
  • Certain drug reactions, such as antipsychotic or anti-nausea medications
  • Genetic disorders


Dystonic Symptoms


Dystonia is characterized by abnormal movements that occur suddenly and are sometimes accompanied by pain. People with dystonia can do one type of movement, such as a downward motion, or perform several combinations of movements.

Symptoms of dystonia can start in the neck, arms or face. These symptoms will get worse over time, and may be exacerbated by fatigue, stress, or anxiety.

Body parts that can be affected by dystonia include:

  • Head and neck

Sufferers can make circular movements or random movements such as forwards, backwards, or sideways to the right and left. Abnormal movements in the head are usually accompanied by pain.

  • Eyelid

Dystonia can cause the eyelids to blink faster or to close tightly involuntarily (blepharospasm). This blinking is not accompanied by pain, but will occur more often when experiencing stress, interacting with people, or in a room with bright lights.

  • Jaws or tongue

Dystonia of the jaw or tongue can cause speech to be slurred or even difficult to speak. Sufferers can also salivate, and have difficulty chewing or swallowing.

  • Vocal cords

Vocal cords affected by dystonia will change the voice to a loud or low whisper.

  • Hand

Some types of dystonia occur when the hand performs repetitive activities, such as writing or playing a musical instrument.

When to see a doctor

The early symptoms of dystonia are often mild, but they shouldn't be ignored. Immediately do an examination to the doctor if the body moves unnaturally and unintentionally. It should be noted, the symptoms of dystonia will get worse over time.

Diagnostics of Dystonia


The doctor will ask questions regarding the symptoms you are experiencing and a family history of dystonia. After that, the patient will be advised to undergo the following examinations:

  • Blood and urine tests, to detect infections or toxic substances in the patient's body, as well as to assess the function of the body's organs as a whole
  • Scans, such as a brain MRI, to check for abnormalities in the brain, such as a stroke or tumor
  • Electromyography (EMG), to assess electrical activity in the muscles
  • Genetic tests, to detect genetic disorders associated with dystonia, such as Huntington's disease


Based on the results of the examination, the doctor will determine the type of dystonia experienced and the appropriate treatment method.

Dystonia Treatment


Until now, there is no known treatment that can cure dystonia. However, there are several treatments to reduce the frequency of symptoms and their severity, namely:

  • Drugs

The drugs given aim to affect signals in the brain, for example anticholinergic drugs, such as trihexyphenidyl; gamma aminobutyric acid (GABA) regulatory drugs, eg diazepam and lorazepam; as well as dopamine drugs, such as levodopa.

  • Physiotherapy

The doctor may advise the patient to undergo physiotherapy, to retrain the affected muscles.

  • Operation

Surgery is done when other treatments have not worked. Operations aim to stimulate the brain with electric currents (deep brain stimulation), or cut the nerves of the affected muscles (selective denervation and surgery).

  • Botox injections (botulinum toxin)

This drug will be injected directly into the area of the body affected by dystonia and needs to be repeated every 3 months. It is important to remember, the injection must be under the supervision of a doctor.

Dystonic complications


There are several complications that can be experienced by sufferers of dystonia, namely:

  • It is difficult to move because there are obstacles in moving
  • Difficulty swallowing or speaking
  • Difficulty in seeing, if dystonia affects the eyelids
  • Psychological disorders, such as anxiety disorders or depression
  • Fatigue and pain due to continuous muscle contractions


Dystonia Prevention


Because the cause is unknown, dystonia cannot be prevented. However, the following steps can be taken to prevent dystonia from worsening:

  • Manage stress well
  • Get enough rest and sleep
  • Consult a doctor and carry out a medical examination if you have a history or risk factors for stroke

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