Dystonia is a movement disorder manifested by involuntary contractions of muscles. This disease poses negative influence on the quality of life and it is more common in children and adolescents.
What is Dystonia?
Dystonia is the third most common movement disorder following Parkinson’s disease and Essential Tremor, but it is not widely known in general population. It is manifested by muscle contractions in various body parts. Those muscle contractions lead to abnormal postures and twisting movements. Dystonic contractions may involve various body parts. It may develop in face, vocal cords, neck, arms or legs. Severity of those contractions is not identical in all patients. Some patients may, therefore, need aid and caregivers.
Causes of dystonia are divided into two groups.
- Primary Dystonia
It is more prevalent in young people. The etiology is not known. Stress does not cause dystonia. Stress only aggravates complaints of patients with dystonia.
- Secondary Dystonia
This group of dystonia is secondary to cerebral palsy in children with cerebral palsy caused by postnatal infections.
Diagnosis And Treatment
Final diagnosis of the disease is made by a neurologist with clinical examination and MRI scan. However, MRI findings are usually normal in patients with primary dystonia.
First, medication treatment is prescribed to alleviate muscle contractions in patients with dystonia. Besides medication treatment, Botox practices are among the modalities used for treatment of the disease. Botox blocks effects of substances released from nerve ends on muscles. Thus, it contributes to alleviation of contractions. However, the effect is limited to several months. Therefore, it should be repeated.
Surgery is required for patients who do not benefit from medication, Botox and physiotherapy. At this point, it is very crucial not to be late for surgical treatment. In case of being late, surgical procedures do not offer the expected benefit. Surgical outcomes are substantially successful in patients who are timely treated.
As is the case with other movement disorders, deep brain stimulation is used in Dystonia. Special electrodes are inserted into certain regions of the patient’s brain. The other end of the electrode is connected to a pacemaker placed beneath the clavicle and thus, electric current is transmitted to that part of the brain and involuntary contractions are suppressed. The battery is adjusted in follow-up visits at certain intervals following the surgery. The patient can resume a routine life 2 to 3 months later.
Another treatment modality used for treatment of dystonic patients is needle ablation. A needle is inserted into the center of brain that causes the contractions and the region is ablated.