What is a dystonia storm and why does it need to be addressed?

Dystonia causes involuntary muscle contraction and may result in repetitive twisting. Read on to know more about this movement disorder.
Dystonia is a serious disorder. Image courtesy: Shutterstock
Dr Dhanashree Peddawad Published: 6 Oct 2022, 06:05 pm IST
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Dystonias are rare neurologic disorders that cause the muscles to contract involuntarily and bring about repetitive or twisting movements. The condition can either affect specific parts of your body or the whole and cause painful muscle spasms which can interfere with your day-to-day tasks.

Causes of dystonia

While some cases of dystonia are genetic and may run in families, others result from environmental factors, such as exposure to toxins, damage to the brain, or the use of some medications. In many cases, the cause of the disease is not clear. The rare condition has no cure; however, medications and therapy can help manage the symptoms. In some cases, surgery is used to regulate or disable certain regions of the brain in people with severe dystonia.

Apart from environmental factors, other health conditions that can act as a trigger for dystonia include brain hemorrhage, lack of oxygen to the brain, stroke, infections such as encephalitis, use of drugs such as antipsychotics, brain tumor, traumatic brain or spine injury and Wilson’s disease. Additionally, some types of dystonia could be found in individuals having problems with basal ganglia – a part of the brain responsible for controlling involuntary movements. However, some researchers suggest that other regions of the brain may also be involved as this does not explain all the different types of dystonia.

Dystonia is a movement problem. Image courtesy: Shutterstock

Here are symptoms of dystonia:

The symptoms of the disease vary in their intensity and can impact different parts of the body depending on the type of dystonia. In some cases, the condition can affect posture as well. The symptoms can be painful, accompanied by tremor or other neurological symptoms. While specific symptoms will depend on the type of dystonia, common examples include foot cramps, a dragging leg or worsening of handwriting after a couple of lines. Others are twisting or shaking movements, repetitive movements such as uncontrollable blinking, difficulty speaking, involuntary pulling, etc.

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Symptoms may worsen with stress, fatigue or prolonged activity and improve with rest and relaxation methods. In some cases, they can turn worse with time. A person may have symptoms only in one area which can later spread to other parts of the body. Also, the length of time a person experiences symptoms can also vary, for some it can last for seconds or minutes and for others it can continue for weeks or months.

Is there any treatment for dystonia?

Dystonias are usually lifelong conditions and learning as much as possible about them can help a person manage their health and improve their quality of life. The treatment depends on various factors such as the cause and type of the condition. There is currently no cure, but the following medications may help relieve symptoms:

  • Botulinum toxin (Botox) injections block the release of the neurotransmitter responsible for muscle contraction
  • Dopaminergic agents work to boost or lower brain levels of dopamine, a neurotransmitter involved in movement.
  • Anticholinergics work by blocking the release of acetylcholine.
    Regulation of neurotransmitter GABA with muscle relaxants, such as diazepam
Physiotherapy can help people with dystonia by improving movement and mobility. Image courtesy: Shutterstock

Other than medications, physical therapy can help to manage posture and help patients learn some physical tricks that can be of help to relieve the symptoms of some types of dystonia. In some, speech therapy and biofeedback may be helpful. Surgery may be recommended in cases where other therapies do not help. Deep brain stimulation is used for some and involves placing tiny electrodes in the basal ganglia, and a pulse generator. It helps block abnormal nerve impulses produced by the basal ganglia and may help reduce unwanted movements.

In summation, dystonias are rare disorders that have no cure. Therefore, treatment is directed at relieving symptoms and improving quality of life for individuals with the condition.

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About the Author

Dr Dhanashree Peddawad, Consultant – Neurologist, Jupiter Hospital Pune ...Read More

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