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Focal Dystonia

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Condition

Focal Dystonia

Definition

Focal dystonia (FD) is an uncontrolled 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 (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

Treatment can help manage FD.

Causes

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

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

The Process of Carbon Monoxide Poisoning Decreasing Available Oxygen.

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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

Symptoms of FD may be:

  • Eyelid spasms
  • Fast 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 symptoms and past health. A physical exam will be done. The person may be sent to 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 with:

Electroencephalography.

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Treatment

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

  • Botulinum toxin injected into a muscle—to weaken the muscle
  • One or more medicines, such as:
    • Over the counter or prescription pain medicine
    • Anticholinergics
    • Benzodiazepines
    • Dopaminergic agents
    • Dopamine-depleting agents
    • Antiseizure medicine

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 focal dystonia.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • 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.
  • Dystonia. The Canadian Movement Disorder Group website. Available at: http://www.cmdg.org/Movement_/dystonia/dystonia.htm.
  • Dystonia. International Parkinson Movement Disorder Society website. Available at: http://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Dystonia.htm.
  • Dystonias fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/dystonias-fact-sheet.
  • Meige Syndrome. National Organization for Rare Disorders. Available at: http://rarediseases.org/rare-diseases/meige-syndrome.
  • 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.

Contributors

  • Daniel A. Ostrovsky, MD
Last Updated:
2022-09-01

(C) Copyright 2022 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.