What is the best treatment for dystonia?
Request an Appointment 410-502-0133 Dystonia Treatment at Johns Hopkins: What to Expect Kelly Mills, M.D., Co-Director of the Neuromodulation and Advanced Treatments Center During your initial evaluation with our multidisciplinary team, we will listen to you and assess the impact of dystonia on your everyday activities and goals.
What kind of doctor should I See for dystonia?
The DMRF maintains a directory of physicians and healthcare providers with experience and/or interest in treating people with dystonia. Please note that the professionals listed in this directory vary in their experience and specific areas of expertise and have voluntarily chosen to be listed.
Which areas of the body are affected by dystonia?
In most cases, the appropriate doctor to treat dystonia is a movement disorder neurologist. Establishing a treatment plan requires open communication and patience on the part of both the affected individual and the physician. Make the effort to locate the most experienced physician you can, and someone with whom you feel comfortable.
What kind of doctor can diagnose dystonia?
Primary care physicians are often the first to see patients with symptoms of dystonia; however, it is important to be evaluated at an advanced brain center as soon as possible, since early and expert intervention can ensure proper diagnosis and effective treatment.
What is the best treatment for dystonia?
Physical therapy and occupational therapy can be useful in many patients. Botulinum toxin is currently the mainstay of treatment for focal and segmental dystonia, while oral medications and DBS are the mainstays of therapy for generalized dystonia.
Do neurologists treat dystonia?
Because dystonia can also be indicative of other conditions, our neurologists thoroughly evaluate each patient and run all necessary tests to determine why they are experiencing symptoms. For many patients with dystonia, medications or Botox treatments may adequately treat their condition.
How do doctors treat dystonia?
A number of different medications can be tried to treat dystonia, such as drugs that affect the specific neurotransmitters acetylcholine, GABA, and dopamine. Other drugs that your doctor might prescribe are anticonvulsants and even injections of Botulinum toxin (Botox).
Can dystonia be fixed?
Dystonia has no cure, but you can do a number of things to minimize its effects: Sensory tricks to reduce spasms. Touching certain parts of your body may cause spasms to stop temporarily.
Can dystonia just go away?
There's no cure for dystonia. But medications can improve symptoms. Surgery is sometimes used to disable or regulate nerves or certain brain regions in people with severe dystonia.
Are there any new treatments for dystonia?
Antiviral Drug Corrects Dystonic Brain Abnormalities A team of researchers from Duke University led by past DMRF grant recipient and current member of the MSAC, Dr. Nicole Calakos discovered that an existing FDA-approved drug corrects dystonia-specific brain changes in a mouse model of DYT-TOR1A dystonia.
Does Benadryl help dystonia?
Oral Medications Unfortunately, few medications are completely effective for the treatment of dystonia. Exceptions to this rule include the use of Benadryl to treat acute drug-induced dystonia and the use of dopamine to treat certain forms of inherited dystonia, such as Segawa syndrome.
What causes adult dystonia?
Primary dystonia may be inherited or occur for unknown reasons (idiopathic). Secondary dystonia referred to cases in which dystonia resulted from a broad range of causes including genetic mutations, birth injury, stroke, brain tumors, certain infections, and as a reaction to certain drugs.
Can a chiropractor help with dystonia?
Chiropractic should be considered as a non-invasive management for the structural and neurological problems that cause dystonia.
Does dystonia show up on MRI?
Researchers at Harvard Medical School and Massachusetts Eye and Ear have developed a unique diagnostic tool that can detect dystonia from MRI scans—the first technology of its kind to provide an objective diagnosis of the disorder.
Is dystonia a neurological disorder?
Dystonia is a neurological movement disorder that results in unwanted muscle contractions or spasms. The involuntary twisting, repetitive motions, or abnormal postures associated with dystonia can affect anyone at any age.
How to treat dystonia?
Treatment of dystonia begins with proper diagnosis and classification, followed by an appropriate search for underlying etiology, and an assessment of the functional impairment associated with the dystonia. The therapeutic approach, which is usually limited to symptomatic therapy, must then be tailored to the individual needs of the patient.
What is the best medication for dystonia?
Anticholinergic agents are generally the most successful oral medications for the treatment of dystonia, with trihexyphenidyl being the most commonly used agent. In a prospective, double-blind trial of high-dose trihexyphenidyl, Burke and colleagues found a clinically significant improvement in 71% of 31 patients (mean age 19 years) on an average daily dose of 30 mg daily during a 36-week study period [6]. No prospective, double-blind, placebo-controlled trials have been conducted in older adults. Other anticholinergic agents have been used with variable success including benztropine, biperiden, atropine, procyclidine, orphenadrine, and scopolamine. Patients started on anticholinergic agents within 5 years of onset are more likely to experience therapeutic benefit [7].
What are the different types of dystonia?
Examples include blepharospasm (periocular muscles), cervical dystonia (spasmodic torticollis), laryngeal (spasmodic dysphonia) dystonia, oromandibular dystonia, and limb dystonia. Segmental dystonias involve two or more contiguous regions. Meige’s syndrome (blepharospasm plus oromandibular dystonia) is one of the more common examples. Multifocal dystonias involve two or more non-contiguous regions, while hemidystonia involves one side of the body (e.g., ipsilateral arm and leg). Generalized dystonias are more widespread, involving both legs and at least one other body region. Classification by age of onset also is valuable because those with onset before age 30 (young-onset disease) are more likely to have a discoverable condition that often evolves into a more generalized form, while those with onset after age 30 (adult-onset disease) are more likely to have a more focal form with little progression but no discoverable cause. Lastly, the dystonias can be classified as primary or idiopathic, when accompanying features are absent, versus secondary, when dystonia is due to an identifiable cause (e.g., neurodegenerative diseases, stroke, trauma, demyelinating disease, drugs, etc).
What is dystonia in a patient?
Dystonia is a neurological syndrome characterized by involuntary twisting movements and unnatural postures. It has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions.
What is dystonia in medical terms?
Dystonia is a neurological condition with a broad range of clinical manifestations that can emerge at any age. It is defined as a syndrome of involuntary movement that manifests as excessive muscle contractions that frequently cause twisting and repetitive movements or abnormal postures.
Which type of dystonia involves two or more contiguous regions?
Segmental dystonias involve two or more contiguous regions. Meige’s syndrome (blepharospasm plus oromandibular dystonia) is one of the more common examples. Multifocal dystonias involve two or more non-contiguous regions, while hemidystonia involves one side of the body (e.g., ipsilateral arm and leg).
How often should I take trihexyphenidyl?
Trihexyphenidyl is started at 1 mg daily and increased by 1 mg every 3 – 5 days over a period of 1 month to a goal dose of 2 mg t.i.d.. It can then be increased by 2-mg increments every week until side effects emerge or a dose of 30 mg t.i.d. is reached.
What is the treatment for dystonia?
Our dystonia specialists offer a wide range of treatments for all forms of dystonia, including botulinum toxin therapy; physical, occupational and speech therapy; and even deep brain stimulation.
What is the link between dystonia and calcium?
Researchers at Johns Hopkins were among the first to link dystonia with abnormal communication involving calcium among nerve cells. These studies led to a clinical trial of medications that influence calcium signaling in people with dystonia.
Can dystonia occur in musicians?
Certain types of task-specific dystonia can occur in people whose profession requires repetitive movements, including musicians and other performers. Alexander Pantelyat, M.D., a movement disorders neurologist and co-director of the Johns Hopkins Center for Music & Medicine, has a particular interest in helping musicians afflicted with this disorder.
Is dystonia a movement disorder?
Dystonia is a common problem seen in movement disorder clinics, but its many different and unusual manifestations can make it a challenge to diagnose. If you suspect you or someone in your family has dystonia, you can benefit from clinical evaluation by our movement disorder experts who can provide an accurate diagnosis and effective treatments.
Can botulinum toxin be used for focal dystonia?
Many cases of focal dystonia can be treated with botulinum toxin injection, which can virtually eliminate the jerky posturing of the head in torticollis or the eye spasms of blepharospasm. Some children with generalized dystonia, known as dopa-responsive dystonia, respond dramatically to levodopa and related medications.
What is the best doctor for dystonia?
In most cases, the appropriate doctor to treat dystonia is a movement disorder neurologist. Establishing a treatment plan requires open communication and patience on the part of both the affected individual and the physician.
What is the purpose of a muscle spasm treatment?
The purpose of treatment is to lessen the symptoms of muscle spasms, pain, and involuntary movements/postures. The ultimate goal is to improve quality of life and help you function with the fewest side effects possible.
Is dystonia a movement disorder?
Dystonia is a Movement Disorder. Dystonia treatment is not one size fits all. Treatment for dystonia must be customized to the individual person. Although there is not yet a cure, multiple treatment options are available. The purpose of treatment is to lessen the symptoms of muscle spasms, pain, and involuntary movements/postures.
How do you know if you have dystonia?
Early signs of dystonia often are mild, occasional and linked to a specific activity. See your doctor if you're experiencing involuntary muscle contractions.
What is the term for a muscle spasm that causes repetitive movements?
Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements. The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia). The muscle spasms can range from mild to severe.
Is dystonia inherited?
The exact cause of dystonia isn't known. But it might involve altered nerve-cell communication in several regions of the brain. Some forms of dystonia are inherited.
Is there a cure for dystonia?
The muscle spasms can range from mild to severe. They may be painful, and they can interfere with your performance of day-to-day tasks. There's no cure for dystonia.
Can oromandibular dystonia cause slurred speech?
You might experience slurred speech, drooling, and difficulty chewing or swallowing. Oromandibular dystonia can be painful and often occurs in combination with cervical dystonia or blepharospasms. Voice box and vocal cords (spasmodic dystonia). You might have a tight or whispering voice.
What kind of doctor can diagnose dystonia?
Individuals with dystonia are encouraged to seek treatment from a neurologist with special training in movement disorders. A movement disorder specialist can diagnose—or rule out—lower limb dystonia and assess any possible underlying causes. A team of medical professionals with various specialties may be appropriate to tailor treatment to the specific needs of the individual.
How to tell if you have dystonia?
Common symptoms of lower limb dystonia include: • Foot rolls outward so that the sole faces inward. • Foot or leg turns inward. • Foot points downward. • Extension of big toe. • Toe curling. • A sense of tightness or stiffness in the limb. • Changes in walking or running gait. Dystonia affects men, women, and children of all ages and backgrounds.
What is the term for dystonia of the lower leg?
Lower Limb Dystonia. Dystonia of the Leg or Foot. Lower limb dystonia refers to dystonic movements and postures in the leg, foot, and/or toes. It may also be referred to as focal dystonia of the foot or leg. Individuals often have to adapt their gait while walking or running to compensate for the dystonic symptoms, ...
When does lower limb dystonia occur?
When seen in adults, lower limb dystonia seems to affect women more often than men. Age of onset is typically in the mid-40s. Symptoms may develop after periods of prolonged exercise, for example long-distance running or long-distance walking. Symptoms are often triggered by running, walking, or standing but may be absent at rest. Electrolyte disturbances and disorders of energy metabolism must be ruled out if symptoms occur only with exertion and fatigue.
Does AFO help with dystonia?
A light weight ankle foot orthotic (AFO) may worsen dystonia in some and improve walking in others. Physicians and rehabilitation therapists are beginning to explore the use of wearable stimulation devices to reduce lower limb dystonia with some success.
Is dystonia a symptom of Parkinson's disease?
Dystonia is not a typical early symptom of Parkinson’s disease but, in rare cases, lower limb dystonia appears to be an early sign of certain parkinsonian conditions. For example, toe pointing or curling triggered by exercise has been documented in individuals ultimately diagnosed with young-onset Parkinson’s disease, ...
Is dystonia inherited?
Dystonia affects men, women, and children of all ages and backgrounds. In children, lower limb dystonia may be an early symptom of an inherited dystonia. In these cases, the dystonia may eventually generalize to affect additional areas of the body. Children with cerebral palsy may have limb dystonia, often with spasticity ...
What drugs are used for dystonia?
These drugs include Sinemet (levodopa) or Parlodel (bromocriptine). Drugs that block or deplete dopamine are generally discouraged from use in treating dystonia because of the risk of tardive syndromes which may worsen movement symptoms.
Does oral medication help with dystonia?
Numerous oral medications have been shown to improve dystonia. No single drug works for everyone, and several trials of medications may be needed to determine which is most appropriate for you. It is essential to clearly communicate with your doctors about all medications you are taking.
Overview
- Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements.The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia). The muscle spasms can range from mild to severe. They may be painful, and they can interfere with your per…
Treatment
- To manage your muscle contractions, your doctor might recommend a combination of medications, therapy or surgery.
- Doctors typically take an individualized approach and use a combination of methods to help you manage pain and reduce muscle spasms. A number of different medications can be tried to treat dystonia, such as drugs that affect the specific neurotransmitters acetylcholine, GABA, and dopamine. Other drugs that your doctor might prescribe are anticonvulsants and even injection…
Symptoms
- Dystonic reactions (ie, dyskinesias) are characterized by intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, extremities, and even the larynx. [1, 2] Although dystonic reactions are rarely life threatening, the adverse effects often cause distress for patients and families.
- Dystonia affects different people in varying ways. Muscle contractions might: 1. Begin in a single area, such as your leg, neck or arm. Focal dystonia that begins after age 21 usually starts in the neck, arm or face and tends to remain focal or segmental. 2. Occur during a specific action, such as handwriting. 3. Worsen with stress, fatigue or anxiety. 4. Become more noticeable over time.…
- Symptoms may start slowly—you might notice that your handwriting is deteriorating. Sometimes you may get cramps in the feet or, more noticeably, you may lose control over a foot and find that it contracts or drags along.Other symptoms of dystonia can include: 1. Involuntary and rapid blinking that you can't stop 2. A sudden tightening or turning of the neck to one side, particularly …
Diagnosis
- To diagnose dystonia, your doctor will start with a medical history and physical examination.To determine if underlying conditions are causing your symptoms, your doctor might recommend: 1. Blood or urine tests. These tests can reveal signs of toxins or of other conditions. 2. MRI or CT scan. These imaging tests can identify abnormalities in your brain, such as tumors, lesions or ev…
- Diagnosing dystonia is a multistep process because no particular test can give a definitive answer. Your doctor will usually perform a physical exam and evaluate your symptoms, plus take a personal and family history to find out if you have any genetic indications for dystonia.Other tests used to help diagnose dystonia include: 1. Genetic tests to look for known mutations linke…
Causes
- The exact cause of dystonia isn't known. But it might involve altered nerve-cell communication in several regions of the brain. Some forms of dystonia are inherited.Dystonia also can be a symptom of another disease or condition, including: 1. Parkinson's disease 2. Huntington's disease 3. Wilson's disease 4. Traumatic brain injury 5. Birth injury 6. Stroke 7. Brain tumor or ce…
Coping And Support
- Living with dystonia can be difficult and frustrating. Your body might not always move as you would like, and you may be uncomfortable in social situations. You and your family might find it helpful to talk to a therapist or join a support group.
Lifestyle And Home Remedies
- Dystonia has no cure, but you can do a number of things to minimize its effects: 1. Sensory tricks to reduce spasms. Touching certain parts of your body may cause spasms to stop temporarily. 2. Heat or cold. Applying heat or cold can help ease muscle pain. 3. Stress management. Learn effective coping skills to manage stress, such as deep breathing, social support and positive sel…
Alternative Medicine
- Alternative treatments for dystonia haven't been well-studied. Ask your doctor about complementary treatments before you start. Consider: 1. Meditation and deep breathing. Both might ease stress that can worsen spasms. 2. Biofeedback. A therapist uses electronic devices to monitor your body's functions, such as muscle tension, heart rate and blood pressure. You then l…
Complications
- Depending on the type of dystonia, complications can include: 1. Physical disabilities that affect your performance of daily activities or specific tasks 2. Difficulty with vision that affects your eyelids 3. Difficulty with jaw movement, swallowing or speech 4. Pain and fatigue, due to constant contraction of your muscles 5. Depression, anxiety and social withdrawal...
- Some people with dystonia may develop permanent malformations if the muscle spasms lead to constriction of the tendons.
Results
- Forty-nine subjects were referred because of suspected RDP. Mutations in the ATP1A3 gene were found in 36 individuals from 10 families (Table 1), including 26 individuals from seven families reported previously (de Carvalho Aguiar et al., 2004). In the remaining 13 subjects from 11 families (Table 2), no mutations in the ATP1A3 gene were found (de Carvalho Aguiar et al., 2004…