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Dystonia and Botox Injections

Group of movement disorders can be treated

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Updated November 16, 2005

The first thing you notice about "Joey" is that his head is turned and tipped to one side; his left ear rests on his hunched-up left shoulder. He has to turn his whole upper body to look at you. Joey has torticollis, also known as cervical dystonia, meaning that his neck muscles are in an involuntary spasm that forces his head into its painful, abnormal position.

Can affect any part of the body
Dystonia--those painful muscle spasms--can affect any part of the body including:

  • eyelids (blepharospasm)
  • face (oromandibular)
  • vocal cords (dysphonia)
  • arms, legs, or trunk

"Writer's cramp" is dystonia in the hand or arm muscles.

Causes
Dystonia affects people of all ages and ethnic backgrounds. Some forms of it can be inherited; researchers have identified more than 10 genes or chromosome locations associated with the disorder. Dystonia may also occur due to birth injury, traumatic injury, toxins (such as manganese), certain medications (such as haloperidol), stroke, or be part of another disorder such as Parkinson's disease. It generally develops gradually, and symptoms can appear at any age.

Diagnosis
There is no specific test for dystonia, so it is usually diagnosed based on the symptoms. Dystonia can come and go, so some people who experience it may have a hard time convincing health care providers that it exists. The spasms may change significantly with different actions. For example, hand dystonia may occur when trying to write but not during other activities.

Treatment
For most people with dystonia, the disorder does not shorten life, but it does cause pain and discomfort, and may interfere with basic activities such as walking, dressing, or eating.

There are a number of medications that can treat dystonia, either alone or in combination. One of the most common treatments is Botox (botulinum toxin) injections (marketed as Vistabel in Europe). Dysport is another brand available in Europe. Another formulation of botulinum toxin used is called Myobloc (U.S.) or Neurobloc (Europe).

Botox injections
Although most people in the U.S. know Botox as a vanity treatment for facial lines, it was originally developed in 1989 as an orphan drug to treat dystonia and muscle spasms. Injection of the drug causes weakness in the targeted muscle, thus relaxing the spasm and relieving dystonia.

Information for this article was taken from:
- Molloy, F. M. (2002). Botulinum toxin (Botox): Dystonia treatment. eMedicine, accessed at http://www.emedicine.com/neuro/topic585.htm
- Dystonia Medical Research Foundation

Last updated 11/15/05

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