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Focal Dystonia

How to Say It: Fo-kul dis-tone -ee-uh

by Cynthia M. Johnson, MA

Home | Health Information Center | Disease, Condition, & Injury Fact Sheets | Article

Definition

Focal dystonia (FD) is a movement problem that happens in one part of the body. A person may have unusual movements, twitches, and tics. It may happen all the time or off and on. The most common types are:

Blepharospasm—an eye twitch
Cervical dystonia or spasmodic torticollis—happens to the neck
Segmental cranial dystonia, also known as Meige syndrome—happens to the jaw, tongue, and eyes
Oromandibular dystonia—happens to the jaw
Spasmodic dysphonia—happens to the vocal cords
Axial dystonia—happens to the trunk
Dystonia of the hand/arm, such as writer's cramp

Causes

In most people, the cause is not known. In others, it may be due to genes.

FD can also be caused by a health problem or injury, such as:

Infection
Reactions to medicines
Problems during birth, such as lack of oxygen
Trauma
Heavy metals in the body
Carbon monoxide poisoning
Stroke

The Process of Carbon Monoxide Poisoning Decreasing Available Oxygen

Risk Factors

FD is more common in people who have family members who have it.

It is also more common in people who have a health problem or injury that raises the risk.

Symptoms

Problems may be:

Eyelid spasms
Rapid or uncontrollable blinking of both eyes
Neck twisting
Problems writing
Foot cramps
Pulling or dragging of a foot
Shaking
Problems speaking

FD may get worse with:

Excitement
Stress
Talking
Being tired

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. You may be sent to see a doctor who treats the nervous system. A neurologic exam may be done.

There are no tests to confirm FD. These tests may be done to rule out other problems:

Lab tests, such as blood, urine, and genetic testing
Lumbar puncture to look at the fluid surrounding the brain and spine

The electrical activity of the muscles, nerves, and brain may need to be measured. This can be done with:

Pictures may be taken of the head. This can be done with:

MRI scan
CT scan
Ultrasound

Electroencephalography

Treatment

The goal of treatment is to manage symptoms. Options are:

Medications

The doctor may give one or more medicines:

Over the counter or prescription pain medicine
Anticholinergics
Benzodiazepines
Dopaminergic agents
Dopamine-depleting agents
Antiseizure medicine

Botulinum Toxin Injections

Injecting botulinum toxin into a muscle can weaken the muscle. The effect may last for 3 to 4 months.

Surgery

Surgery may be done to:

Cut the nerves leading to muscles or to remove the muscles
Destroy the small site within the brain where dystonia occurs
Implant electrodes in the brain to control muscle movements

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

Dystonia Medical Research Foundation
https://www.dystonia-foundation.org

International Parkinson and Movement Disorder Society
http://www.movementdisorders.org

CANADIAN RESOURCES:

Canadian Movement Disorder Group
http://www.cmdg.org

Health Canada
https://www.canada.ca

References:

Albanese A, Bhatia K, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013 Jun 15;28(7):863-873.

Carrechio M, Mencacci NE. Emerging monogenic complex hyperkinetic disorders. Curr Neurol Neurosci Rep. 2017;17(12):97.

Cervical dystonia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cervical-dystonia. Accessed October 22, 2020.

Dystonia. The Canadian Movement Disorder Group website. Available at:
...(Click grey area to select URL)
Accessed October 22, 2020.

Dystonia. International Parkinson Movement Disorder Society website. Available at:
...(Click grey area to select URL)
Accessed October 22, 2020.

Dystonias information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Dystonias-Fact-Sheet. Accessed October 22, 2020.

Meige Syndrome. National Organization for Rare Disorders. Available at:
...(Click grey area to select URL)
Accessed October 22, 2020.

Newby RE, Thorpe DE, et al. A history of dystonia: ancient to modern. Mov Disord Clin Pract. 2017;4(4):478-485.

What is dystonia? Dystonia Medical Research Foundation website. Available at: https://www.dystonia-foundation.org/what-is-dystonia. Accessed October 22, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 5/18/2021

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