What Is Dystonia?
Dystonia is a neurologic disorder that causes abnormal, involuntary muscle contractions resulting in twisting and repetitive movements. It may affect one muscle or a group of muscles. Dystonia is the third most common movement disorder (after essential tremor and Parkinson’s disease) and affects about 1 percent of the population — up to 250,000 people in the United States.
Neurologists at NewYork-Presbyterian offer comprehensive diagnostic services and the latest treatments for people with dystonia.
Types of Dystonia
There are several types of dystonia, differing in how they affect the body and the underlying cause:
- Blepharospasm causes increased and forcible blinking
- Cervical dystonia (also called spasmodic torticollis or torticollis) affects the neck muscles, causing the head to turn to one side or to be pulled backward or forward
- Cranial dystonia affects the head, face, and neck and includes oromandibular dystonia (causing difficulty opening and closing the jaw and possibly with speech and swallowing) and spasmodic dysphonia (laryngeal dystonia, affecting the muscles that control the vocal cords and resulting in strained speech)
- Tardive dystonia is a side effect of certain medications and causes erratic facial movements, such as lip smacking, rapid blinking, and thrusting of the tongue
- Paroxysmal dystonia causes erratic muscle movements only at certain times
- Writer’s cramp is a form of task-specific dystonia that only occurs during handwriting
- Musician’s dystonia occurs when a musician is playing an instrument, and affects the part of the body they use to make music, such as the hands for keyboard players, the lips for horn players, or the voice for singers
Classifications of Dystonia
Dystonia is classified according to the part of the body that is affected.
- Generalized dystonia affects all or most of the body
- Focal dystonia is isolated to one part of the body
- Multifocal dystonia affects two or more unrelated body parts
- Segmental dystonia involves two or more parts of the body next to each other
- Hemidystonia affects an arm and leg on the same side of the body
Signs & Symptoms of Dystonia
The symptoms of dystonia often appear during specific movements. As the disorder becomes more advanced, symptoms may occur while at rest.
Common dystonia symptoms include:
- A dragging leg or cramping foot, either sporadically or after running or walking a long distance
- Pulling of the neck area, especially when tired or under stress
- Uncontrollable and rapid blinking
- Trouble speaking
- Hand cramping after writing several lines
What Causes Dystonia?
Dystonia is believed to arise from an abnormality in the brain that affects neurotransmitters, chemicals that help brain cells communicate with each other. In most cases, the cause of dystonia cannot be identified. Dystonias may be grouped as:
- Idiopathic dystonia means there is no known cause
- Genetic dystonia is a rare form of dystonia caused by a genetic mutation in the DYT1 gene. Dopa-responsive dystonia, also called Segawa’s disease, is caused by a mutation in the DYT5 gene. Several other mutations in the DYT genes have been identified as causing various types of dystonia.
- Acquired (secondary) dystonia is caused by an external factor, such as infections, trauma, stroke, certain medications, or exposure to certain toxins
Risk Factors for Dystonia
Other neurologic disorders may cause what is known as “heredodegenerative dystonia.” People with these diseases may experience dystonia symptoms:
- Huntington’s disease
- Wilson’s disease
- Parkinson’s disease
- Rett syndrome
- Juvenile parkinsonism
- X-linked dystonia-parkinsonism
Other risk factors for dystonia include:
For some people, dystonia symptoms plateau after a while and do not get worse. For others, the disorder steadily gets worse, causing abnormal walking and fixed deformities in posture. While dystonia itself does not cause pain, it can lead to pain due to degeneration of the spine, irritation of nerve roots, frequent headaches, limb pain, or arthritis. Patients may also experience depression or anxiety.
Trust NewYork-Presbyterian for Dystonia Care
NewYork-Presbyterian offers dystonia care through two dedicated movement disorder centers: Columbia's Center for Parkinson’s Disease and Other Movement Disorders and Weill Cornell’s Parkinson’s Disease and Movement Disorders Institute.
We have expertise and experience caring for people with all types and stages of dystonia and will tailor your treatment to your needs. Make an appointment for a consultation and learn how we can help.