The Latest Treatment for Dystonia
Dystonia is a neurological disorder that causes involuntary contractions that affect movement. Deep brain stimulation can be used to control movement coordination.
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Dystonia is a highly complex and highly variable neurological movement disorder characterized by involuntary muscle contractions. It is a condition that knows no age, ethnicity, or race.
Dystonia results from dysfunction in a deep part of the brain that helps control movement coordination. These areas of the brain control the speed and smoothness of movement and prevent unwanted movements. Patients with dystonia may experience uncontrollable twisting, repetitive movements, or abnormal postures. These can affect any part of the body, including the arms, legs, trunk, face, and vocal cords.
Causes of dystonia:
Dystonia is caused by a problem in the part of the brain that controls movement. Often, the cause is unknown. Sometimes, it may be due to:
• Genetic problem.
• A side effect of some medications, such as antipsychotic drugs and anti-nausea drugs.
• Parkinson's disease.
• Stroke.
• Cerebral palsy.
• Multiple sclerosis.
Symptoms of dystonia:
• Uncontrolled muscle contractions and spasms.
• Twisting of body parts into unusual positions, such as twisting the neck to the side or turning the foot inward.
• Tremors.
• Eye irritation, light sensitivity, and excessive blinking due to blepharospasm.
• Mild facial spasms, difficulty chewing, or changes in speech rhythm due to oromandibular dystonia (OMD).
The progression of dystonia varies widely. For some patients, the disease progresses violently; for others, it stops. For other groups, the dystonia stabilizes in a relatively mild stage and does not progress further. The advanced stage is characterized by rapid, involuntary rhythmic movements, twisting postures, trunk deformities, an abnormal gait, and, ultimately, fixed postural deformities.
Pain is common, especially in cervical dystonia due to spinal degeneration, nerve root irritation, or frequent headaches. Dystonia in the extremities may be painless at first but can become painful over time. Uncontrolled muscle movements can cause joint damage, potentially leading to arthritis.
Treatment options for dystonia:
There is no cure for dystonia, so treatment focuses on symptom relief. The main treatments for dystonia are:
• Botulinum toxin (Botox) is injected directly into the affected muscles to block communication between the nerve and muscle, reducing abnormal movements and postures. The patient needs to repeat these injections approximately every 3 months.
• Medications that affect neurotransmitter levels in the brain can help, but they cause many side effects.
• Deep brain stimulation surgery.
Deep brain stimulation surgery to treat dystonia:
Deep brain stimulation (DBS) is the leading surgical treatment for dystonia if medications and other treatments fail to provide adequate relief, and if symptoms negatively impact quality of life. Dr. Zeiad Yossry, Professor of Neurosurgery and Parkinson's Disease, implants a small device, similar to a pacemaker, under the skin of the chest. The device sends electrical signals through wires placed in specific brain regions responsible for dystonia symptoms. The brain stimulation is adjusted remotely to achieve the appropriate settings for each individual patient, providing targeted and personalized relief.
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