Focal Dystonia

Pronounced: Fo-kul dis-tone -ee-uh

Definition

Focal dystonia (FD) is a movement problem that happens in one part of the body. You 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    TOP

In many cases, the cause of FD is not known. In others, it may be due to genes.

FD can also be caused by a health problem, injury, or your genes. This is called secondary FD.

It may be due to:

The Process of Carbon Monoxide Poisoning Decreasing Available Oxygen

Carbon monoxide poisoning
Copyright © Nucleus Medical Media, Inc.

Risk Factors    TOP

Having people in your family with FD raises your risk of getting it.

Having a health problem, injury, or certain genes also raises your chance of getting secondary FD.

Symptoms    TOP

Symptoms may include:

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

FD may get worse with:

  • Excitement
  • Stress
  • Talking
  • Being tired

Diagnosis    TOP

Your doctor will ask about your symptoms and health history. A physical exam will be done. You may need a neurologic exam and an eye exam. You may be sent to a speech-language pathologist, physical or occupational therapists, and genetic counselors.

You may have:

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

Pictures may need to be taken of your head. This can be done with:

Electroencephalography

EEG
Copyright © Nucleus Medical Media, Inc.

Treatment    TOP

Talk with your doctor about the best plan for you. You may have:

Medications

Your doctor may advise 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. This may help you feel better for 3-4 months.

Surgery    TOP

Surgery to cut the nerves leading to muscles or removing the muscles may help. Also, surgery to destroy the small site within the brain where dystonia occurs may stop or ease FD.

Deep brain stimulation may also help.

Prevention    TOP

FD can’t be prevented. If you take any medicines that may cause FD, talk with your doctor about your risk of getting FD.

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

References:

Carrechio M, Mencacci NE. Emerging monogenic complex hyperkinetic disorders. Curr Neurol Neurosci Rep. 2017;17(12):97.
Cervical dystonia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T132176/Cervical-dystonia. Updated April 13, 2017. Accessed June 20, 2018.
Dystonia. International Parkinson Movement Disorder Society website. Available at:
...(Click grey area to select URL)
Accessed June 20, 2018.
Dystonia. The Canadian Movement Disorder Group website. Available at:
...(Click grey area to select URL)
Accessed June 20, 2018.
Gaenslen A. Transcranial sonography in dystonia. Int Rev Neurobiol. 2010;90:179-187.
Meige Syndrome. National Organization for Rare Disorders. Available at:
...(Click grey area to select URL)
Accessed July 11, 2013.
Newby RE, Thorpe DE, Kempster PA, Alty JE. A history of dystonia: ancient to modern. Mov Disord Clin Pract. 2017;4(4):478-485.
NINDS dystonias information page. National Institute of Neurological Disorders and Stroke website. Available at:
...(Click grey area to select URL)
Updated July 2, 2013. Accessed July 11, 2013.
What is dystonia? Dystonia Medical Research Foundation website. Available at: https://www.dystonia-foundation.org/what-is-dystonia. Accessed July 11, 2013.
Last reviewed June 2018 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 6/19/2018

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

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.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.