• Clinical science

Dystonia

Abstract

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing involuntary movements, fixed postures, or both. The disorder may be idiopathic, hereditary, or acquired. Acquired dystonia is most commonly due to drugs (antipsychotics), metabolic disorders, cerebrovascular disease, or traumatic brain injury. Dystonia is classified according to the anatomic distribution of the symptoms into focal, multifocal, segmental, and generalized dystonia. Treatment involves pharmacologic management with levodopa or anticholinergic agents, as well as treatment of the underlying cause if possible. Focal dystonias respond well to periodic botulinum toxin injections in the affected muscle.

Etiology

Most cases of acute dystonia are caused by antipsychotic drugs!
References:[1][2][3][4][5]

Classification

Dystonia disorders are classified according to the distribution of symptoms in the body.

Focal dystonia

  • Overview
    • Affects a single region of the body
    • The majority of cases are idiopathic.
    • Onset typically in adulthood (usually > 30 years)
    • Patients may have sensory tricks (gestes antagonistes) with which they are able to suppress spasms (e.g., touching the affected region).
  • Conditions

Segmental dystonia

Generalized dystonia

Multifocal dystonia

  • Affects ≥ 2 nonadjacent regions of the body

Hemidystonia

  • Affects the limbs of one half of the body

References:[1][3][6][7][8]

Treatment

All treatments can be used for generalized dystonia, but botulinum toxin injections are typically reserved for focal dystonia.

References:[1][2][9][10][11]