Dystonia: what is it, symptoms, treatment, types, diagnosis


What is Dystonia?

Dystonia is a disease of the nervous system that causes involuntary movement (spasms) of some parts of the body, causing unusual movements and positions. When the problem strikes, the person may be unable to move for a while due to the involuntary contraction of the muscle.

Idiopathic dystonias affect between 2 and 50 people per 1 million. Acquired ones, more frequent, affect 1 per thousand inhabitants. Those who suffer the most from acquired dystonias are people over 50 years of age.


Dystonia can occur for several reasons, such as:

  • Congenital;
  • Genetics;
  • Idiopathic (without apparent cause);
  • Acquired from other problems: stroke, encephalitis, lack of oxygen, head trauma, side effects of medications, repetitive strain injury and intoxication by some heavy metal or carbon monoxide.

What are the types of dystonia?

Dystonia can be divided into two types and several classifications.

There is primary or idiopathic dystonia, which is a condition in which only dystonia is the main symptom, and secondary or symptomatic dystonia, which is the result of some other acquired problem, such as stroke, encephalitis and other problems.

Classifications can be made according to the patient’s age or as types of dystonia.


Early onset is identified before age 21 and the most common is generalized dystonia.


Late appears after 21 years of age, compromising the cranial and / or cervical or arm muscles. It has a tendency to remain in restricted areas of the adjacent muscles, characterizing the segmented or focal forms.

Focal dystonia

It occurs in only one part of the body, such as only in the neck, or only in the hand, or only in the feet.

When it reaches the eyes it is known as focal dystonia blepharospasm, as it affects the muscles of the eyes. First of all it causes irritation in the eyes, the number of blinks increases and the sensitivity to light is also greater.

Oromandibular dystonia

Spasms affect the face, in specific parts, such as the tongue, mouth and jaw. Movements of opening or closing the mouth, as well as articulating words, swallowing and chewing can be hindered.

Spasmodic dysphonia

It compromises the muscles of the vocal cords, making it difficult or impossible to articulate words, in addition to the voice becoming inaudible. Spasms usually occur in the larynx, pharynx and also in the vocal folds. When the voice comes out, it can be half clipped or whispery.

Spasmodic torticollis

The stiff neck is the most common type of dystonia. Various muscles can be affected by altering posture. The neck and / or head can lock, making rotation and deviations to some sides impossible.

Clerk’s cramp

In addition to being very common in registrars, musicians suffer from the problem because of performing a task repeatedly for a long time. The disease can evolve over time and will only improve if there is rest.

Segmental dystonia

This type of dystonia is not restricted to just one part of the body, such as just the hand, or just the neck. In this case, it is common to affect two parts at the same time, such as oromandibular and spasmodic dystonia.


In such cases, the affected muscles are always on the same side of the body and can appear at any age.

Generalized dystonias

It is the most unusual type of dystonia among the others already mentioned. Symptoms are usually slow to appear, but they are progressive. They can appear during childhood, with contractions in the foot (s) when walking and even stopped.

This type of dystonia affects other muscles in the body, causing difficulty when walking and, often, the person needs help to get around and perform daily activities.

Risk factors

A risk factor is genetics. Dystonia is present in hereditary forms, and can be passed from generation to generation. Patients who have the mutation are more likely to have the problem than those who do not.

There are factors that can aggravate the symptoms, they are:

  • Tiredness;
  • Stress;
  • Shortness of breathe;
  • Dehydration;
  • Toxins;
  • Bad eating habits;
  • Psychotropic drugs.

Symptoms of Dystonia

At the beginning of the disease, the symptoms may become imperceptible, but, over time, the intensity and frequency increase, causing the muscle to differentiate itself from others.

The main symptoms are:

  • Cramps;
  • Tremors;
  • Writing problems;
  • Difficulty holding objects;
  • Ache;
  • Increased muscle (hypertonia);
  • Unusual postures, such as deviation in the neck.

Diagnosis of Dystonia

The doctor recommended to treat this type of problem is the neurologist .

As previously mentioned, dystonia can have several causes. And, to diagnose it, several studies and exams can be done. The diagnosis is usually made on the basis of a “tripod”: physical examination, complementary examinations and history.

It is necessary for the doctor to collect good information with the patient, about his or her family history, if there is the use of any specific medication, symptoms, etc.

The tests are neurological, blood tests, genetic tests and neuroimaging.

Dystonia Treatment

Treatments are done in several ways. As there is no specific cause, treatment is done by relieving symptoms.


  • Specialized professionals, such as neurologists or physiatrists, apply botulinum toxin type A (botox) to the affected muscles.
  • Muscle relaxant can be used in cases of generalized dystonia and also in focal.
  • Levodopa can be used in children and adolescents with dystonia in the lower limbs or generalized.


  • Physiotherapy can be indicated to reduce symptoms.
  • Speech therapy can be indicated if the voice is affected.
  • Massages and stretches can also be done to relieve muscle pain.
  • Sensory tricks that help to reduce contractions can be done so that the patient has a better quality of life.


Generally, surgery is only recommended if the symptoms are very severe.

  • Do deep brain stimulation, where electrodes are implanted in the surgery in a specific part of the brain and a generator is also implanted in the chest. This generator sends impulses to the brain to help with muscle control.

alternative medicine

Alternative treatments can be done through:

  • Deep breathing and meditation.
  • Biofeedback, which are electronic devices that monitor the body’s functions, such as muscle tension and stress.
  • Yoga is an alternative to stretch your muscles and improve posture.

Treatment is done in different ways and several specialists can be useful, such as occupational therapists, speech therapists, psychologists and physiotherapists.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living with the problem / Complications

Dystonia has no cure, but it has treatment, as mentioned above, and reducing symptoms is the main objective.

Reducing stress can improve symptoms and using heat or cold techniques helps relieve muscle pain.

If the problem is not treated correctly, several problems can arise, such as social impacts ( depression , social phobia and anxiety ) or, physical problems, such as pain and difficulty in performing basic activities.

The objective is always to reduce the impacts of the disease and increase the patient’s quality of life. Physiotherapy can be indicated so that the affected muscle is worked on to improve the patient’s mobility.


There is no way to prevent the disease, but if any family member has dystonia, there are tests that can identify whether you also have the gene or if you have a chance of transmitting it.