Dystonia is a disorder involving too much or excessive muscle activity. It can affect almost any part of the body including but not limited to the limbs, trunk, neck, face, eyes and even the vocal chords. Dystonia can affect one part of the body, which describes ‘focal’ dystonia, or it can affect many parts of the body, as in ‘generalized’ dystonia. The disorder can occur at any point from childhood to old age. Treatment is often tailored to the areas affected.
Risk Factors
- Genetic
- Traumatic
- Medication induced
- Repetitive action of a group of muscles – writers cramp and musician’s dystonia
- Idiopathic (no clear cause)
Symptoms
- Contractions
- Cramping
- Twisting
- Posturing
- Tremor
Treatment
- Medication
- Behavioral modification
- Deep brain stimulation
- Botulinum toxin therapy – often treats focal dystonias
Resources
- Dystonia Medical Research Foundation
- International Parkinson and Movement Disorder Society
- American Dystonia Society
SPASTICITY
Spasticity refers to an abnormality in muscle tone. More specifically, there is an increase in muscle tone. It is distinguished from another disorder of increased muscle tone referred to as ‘rigidity.’ What separates spasticity from rigidity is that the increase in resistance from a spastic muscle is velocity dependent. That is, the more quickly the affected muscle is stretched, the more resistance it provides. Spasticity can affect just about any muscle that is under voluntary control. Arms and legs are commonly involved but other muscles can be affected such as the vocal cords. The expertise of a neurologist is often required to detect spasticity.
Risk Factors
- Spinal cord injury
- Traumatic brain injury
- Stroke
- Cerebral palsy
- Lou Gehrig’s disease
- Various genetic conditions
- Multiple sclerosis
Symptoms
- Increased muscle tone
- Increased reflexes
- Abnormal ‘Babinski’ signs
- Weakness in the affected limb
- Stiffness
- Muscle spasm
- Joint deformities
- Abnormal limb postures
- Pain
Treatment
- Muscle relaxants – baclofen, tizanidine, dantrolene, clonazepam, and diazepam
- Therapy – physical and occupational
- Surgery – tendon release and baclofen pump implantation
- Botulinum toxin therapy – especially for limb spasticity
Resources