Conditions & Treatments
Dystonia is a neurological movement disorder characterized by involuntary muscle contraction leading to abnormal postures and twisting movements. Several types of dystonia are known and they are classified according to age of onset, distribution of dystonia, and cause. The primary dystonias are diseases that are characterized with only dystonia as their clinical feature. Primary dystonias are classified as early onset or adult onset disease.
Early onset dystonia
The characteristic form of early onset form is called "primary childhood onset dystonia" otherwise known as Oppenheim's dystonia or DYT1 dystonia. This disease begins frequently with dystonia in a limb and with onset under the age of 28. It characteristically progresses to involve other body parts and ultimately becomes generalized.
Adult onset dystonia
The adult onset dystonias are far more common and cervical distribution (otherwise known as spasmodic torticollis) is the most common type.
The adult onset dystonias usually remain localized to specific areas such as neck, face or vocal cords. And they generally do not spread and are much less frequently hereditary.
Cervical dystonia (or spasmodic torticollis)
For cervical dystonia, typical age of onset is around 40 years and women are more affected than men.
The cause of dystonia is unknown although genetic studies may shed some light on this in the next decade. The genetic nature of this disorder has recently come to light as it is autosomal dominant and a number of genes have been isolated.
Diagnosing dystonia involves a combination of information provided to the physician from the patient and tests, including neurological examination, MRI, blood, urine and other lab tests. The physician may also request the patient make certain movements or observe the patient's movements and physical behavior. It is important that the doctor diagnosing dystonia is familiar with related neurological conditions to aid in eliminating other conditions or disorders.
Emory Dystonia Diagnostic Services
The Emory Clinic Movement Disorders Center offers a broad range of diagnostic procedures to accurately identify a specific movement disorder. Neurologists at the center are experts in neurological movement disorders and their diagnosis. The Movement Disorders Center is equipped with the latest innovations in diagnostic tools to aid our physicians in identifying a patient's movement disorder. In addition, our physicians are highly trained to further analyze the nature of a patient's condition to help design an effective treatment plan.
The primary treatment for the focal adult onset dystonias is Botulinum toxin. There are currently two types of toxins - Type A (approved in 1989) and Type B (approved in 1999). The most recent advance in the treatment of dystonia is deep brain stimulation surgery similar to that utilized in Parkinson's disease and essential tremor.
Comprehensive Dystonia Treatment
The Emory Clinic Movement Disorders Center treatments include medicine, surgery and therapeutic procedures, rehabilitation, and psychiatric services for movement disorder patients, including those with dystonia and essential tremor. Surgical treatment for dystonia are provided through the Emory Functional Neurosurgery Program. Emory also offers a botulinum toxin injection program for dystonia, hemifacial spasm, spasticity and other conditions.
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