What Is Dystonia?


Dystonia is a disorder that causes the muscles to move on their own unknowingly. This muscle movement can occur in one member of the body until the whole body. As a result of this muscle movement, dystonia sufferers have strange postures and tremble ( tremor ).

Dystonia itself is not a common disease. It is noted, this disease is experienced by 1% of the world population, with more women than men. Unfortunately, there is still no data on the incidence of dystonia in the Asian region, especially in Indonesia.

Causes of Dystonia
The cause of dystonia is not yet known clearly, but is thought to be related to the inherited genetic abnormality. But there are various factors that trigger the occurrence of dystonia, such as:
  • Disorders of the nervous system, for example Parkinson's disease , multiple sclerosis , cerebral palsy ( cerebral palsy ), brain tumors, and strokes.
  • Infections, such as HIV and inflammation of the brain (encephalitis).
  • Wilson's disease.
  • Huntington's disease.
  • Drugs, such as drugs to treat schizophrenia and anticonvulsants.
  • Head or spinal injury.
The use of donepezil drugs in people with Alzheimer's disease is also thought to trigger neck dystonia.

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Dystonia Symptoms 
Symptoms of dystonia vary greatly depending on the part of the body affected, including:
  • Twitch
  • Trembling ( tremor ).
  • The limbs are in unusual positions, such as a slanted neck.
  • Muscle cramp.
  • Eyes flicker without control.
  • Impaired speaking and swallowing.
This symptom can appear as a child (early dystonia) or when it is an adult (slow dystonia). Symptoms that appear in early dystonia are more common in limbs and spread to other parts of the body. While dystonia that occurs slowly is often only limited to one member of the body, especially the face or neck area.


Dystonia Diagnosis
To diagnose dystonia, the neurologist requires several steps to determine the trigger of the dystonia. The doctor will ask questions like:
  • Age when symptoms appear for the first time.
  • Sequences of affected body parts.
  • Does the disease deteriorate rapidly.
After that, patients will be advised to undergo the following additional checks:
  • Urine and blood tests. This test aims to examine the presence or absence of infections or toxic compounds in the patient's body, as well as to assess the functioning of the body as a whole.
  • Magnetic resonance imaging (MRI). This imaging test is useful for checking whether there are abnormalities in the brain, such as strokes and brain tumors.
  • Electromyography (EMG). This test serves to assess the activity of electricity in the muscle.
  • Genetic test. Taking DNA samples is used to find out whether the patient has a genetic disorder associated with dystonia, such as Huntington's disease .

Dystonia Treatment
Until now there is no known treatment that can cure dystonia. However, there are several treatments to reduce the frequency of occurrence of symptoms and their severity, namely:
  • Medicine . The drugs given are drugs that affect signals in the brain. Some drugs that can be given:
    • Trihexyphenidyl
    • Diazepam
    • Lorazepam
    • Baclofen
    • Clonazepam
  • Botox injections ( botulinum toxin) . This drug will be injected directly into the affected area and needs to be repeated every 3 months.
  • Physiotherapy . Doctors can also recommend doing physiotherapy , to retrain the affected muscles.
  • Operation . The type of surgery recommended by the doctor is to install a special device to drain the electric current to the brain ( deep brain stimulation ), or cut nerves that regulate the affected muscles ( selective denervation and surgery ).

Dystonia Complications 
There are several complications that can be experienced by dystonia sufferers, including:
  • Difficulty in doing daily work because it has obstacles in moving.
  • Difficulty swallowing or talking.
  • Difficulty in seeing, if dystonia attacks the eyelids.
  • Psychological problems, such as anxiety or depression.

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