Dystonia
Posted on 11/30/2011
a neurological muscle disorder characterized by involuntary muscle spasms. Dystonia results from abnormal functioning of the basal ganglia, a deep part of the brain which helps control coordination of movement.
These regions of the brain control the speed and fluidity of movement and prevent unwanted movements. Patients with dsytonia may experience uncontrollable twisting, repetitive movements, or abnormal postures and positions. These can affect any part of the body, including the arms, legs, trunk, eyelids and vocal cords. General dystonia involves the entire body. Focal dystonias involve only one body location, most commonly the neck (spasmodic torticollis), eyelids (blepharospasm), lower face (Meige syndrome), or hand (writer's cramp or limb dystonia). Depending on what part of the body is affected, the condition can be very disabling.
There is a three-tiered approach to treating dystonia: botulinum toxin (botox) injections, medication, and surgery. These may be used alone or in combination. Botox injections help block the communication between the nerve and the muscle and may lessen abnormal movements and postures. Surgery is considered when other treatments have proven ineffective. The goal of surgery is to interrupt the pathways responsible for the abnormal movements at various levels of the nervous system. Some operations purposely damage small regions of the thalamus (thalamotomy), globus pallidus (pallidotomy), or other deep centers in the brain. Deep brain stimulation (DBS) has been tried recently with some success. Other surgeries include cutting nerves leading to the nerve roots deep in the neck close to the spinal cord (anterior cervical rhizotomy) or removing the nerves at the point they enter the contracting muscles (selective peripheral denervation).
