In , the U. Food and Drug Administration approved botulinum toxin type B for treatment of cervical dystonia. Researchers created the new drug after some patients began developing resistance to the type A form. The type B drug has mild to moderate side effects such as dry mouth, dysphagia difficulty swallowing and indigestion. Surgical treatment may be considered if medications and other treatments are not providing adequate relief, and if the symptoms negatively affect quality of life.
The mainstay of surgical treatment for dystonia is deep brain stimulation DBS. During DBS surgery, a battery-powered stimulator similar to a pacemaker is implanted in the body and delivers electrical stimulation to the areas of the brain responsible for causing dystonia symptoms. The stimulation to the brain is adjusted by remote control to achieve the appropriate settings for each individual patient. DBS has replaced other surgical techniques such as stereotactic thalamotomy, pallidotomy, and cervical rhizotomy because of its success and lower risk for side effects.
The benefits of any surgery though should always be weighed carefully against its risks. Although some dystonia patients report significant symptom reduction after surgery, there is no guarantee that surgery will help every individual.
Novel approaches to the treatment of dystonia include gene therapy and transcranial magnetic stimulation. Gene therapy may be a future option for patients with inherited forms of dystonia in which a specific gene is thought to be involved. Gene therapy for dystonia, though, has not yet been tested in patients.
Transcranial magnetic stimulation is also being investigated as a non-invasive stimulation to treat dystonia. So far it has been studied in only small controlled trials for focal hand or cervical dystonia. Additional investigation is needed. For more information on patient stories visit the Dystonia. There are also number of local, national and international support groups addressing some of issues and questions that patients and their families may face after a diagnosis of dystonia is made.
The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information provided is an educational service and is not intended to serve as medical advice.
Joint Providership. Early signs of dystonia often are mild, occasional and linked to a specific activity. See your doctor if you're experiencing involuntary muscle contractions. 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 care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
This content does not have an English version. This content does not have an Arabic version. Overview Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Comella C. Classification and evaluation of dystonia. Dystonia can affect many different parts of the body and the symptoms are different depending upon the form of dystonia. Symptoms may include:. The initial symptoms can be very mild and may be noticeable only after prolonged exertion, stress, or fatigue. Over time, the symptoms may become more noticeable or widespread; sometimes, however, there is little or no progression.
In some cases, dystonia can affect only one specific action, while allowing others to occur unimpeded. For example, a musician may have dystonia when using a hand to play an instrument, but not when using the same hand to type. Dystonia may cause pain due to muscle contractions but typically is not associated with problems thinking or understanding.
Depression and anxiety may occur. Researchers believe that dystonia results from an abnormality in or damage to the basal ganglia or other brain regions that control movement. There also may be abnormalities in the way the brain processes information and generates commands to move. In most cases, no abnormalities are visible using magnetic resonance imaging or other diagnostic imaging. Idiopathic dystonia refers to dystonia that does not have a clear cause. Many instances of dystonia are idiopathic.
There are several genetic causes of dystonia. Symptoms may vary widely in type and severity even among members of the same family.
In some instances, people who inherit the defective gene may not develop dystonia. Having one mutated gene appears to be sufficient to cause the chemical imbalances that may lead to dystonia, but other genetic or even environmental factors may play a role. Forms of dystonia for which the genetic cause is known include:. Recently, researchers have identified other genetic causes of dystonia, including one resulting from mutations in the DYT6 gene. Dystonia caused by DYT6 mutations often presents as cranial dystonia, cervical dystonia, or arm dystonia.
Others have it because of another disease. Researchers think that dystonia may be due to a problem in the part of the brain that handles messages about muscle contractions. There is no cure. Doctors use medicines, Botox injections, surgery, physical therapy, and other treatments to reduce or eliminate muscle spasms and pain. The information on this site should not be used as a substitute for professional medical care or advice.
Contact a health care provider if you have questions about your health. See, Play and Learn No links available.
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