Oromandibular dystonia treatment in India

What is Oromandibular dystonia?

Dystonia is a movement disorder where in your muscles contract involuntarily, causing repetitive or twisting movements. The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia). The muscle spasms can range from mild to severe. They may be painful, and they can interfere with your performance of day-to-day tasks.There's no cure for dystonia. But medications can improve symptoms. Surgery is sometimes used to disable or regulate nerves or certain brain regions in people with severe dystonia.

Symptoms

• Begin in a single area, such as your leg, neck or arm. Focal dystonia that begins after age 21 usually starts in the neck, arm or face and tends to remain focal or segmental.
• Occur during a specific action, such as handwriting.
• Worsen with stress, fatigue or anxiety.
• Become more noticeable over time.

Affected areas

• Neck (cervical dystonia). Contractions cause your head to twist and turn to one side, or pull forward or backward, sometimes causing pain.
• Eyelids. Rapid blinking or involuntary spasms cause your eyes to close (blepharospasms) and make it difficult for you to see. Spasms usually aren't painful but might increase when you're in bright light, under stress or interacting with people.
• Jaw or tongue (oromandibular dystonia). You might experience slurred speech, drooling, and difficulty chewing or swallowing. Oromandibular dystonia can be painful and often occurs in combination with cervical dystonia or blepharospasms.
• Voice box and vocal cords (spasmodic dystonia). You might have a tight or whispering voice.
• Hand and forearm. Some types of dystonia occur only while you do a repetitive activity, such as writing (writer's dystonia) or playing a specific musical instrument (musician's dystonia).

Diagnosis

• Blood or urine tests. These tests can reveal signs of toxins or of other conditions.
• MRI or CT scan. These imaging tests can identify abnormalities in your brain, such as tumors, lesions or evidence of a stroke.
• Electromyography (EMG). This test measures the electrical activity within muscles.
• Genetic testing. Some forms of dystonia are associated with certain genes. Knowing whether these genes are present can help guide treatment.

Treatment

To manage your muscle contractions, your doctor might recommend a combination of medications, therapy or surgery.

Medications

Injections of botulinum toxin (Botox, Dysport, others) into specific muscles might reduce or eliminate your muscle contractions and improve your abnormal postures. Injections are usually repeated every three to four months. Side effects are generally mild and temporary. They can include weakness, dry mouth or voice changes.

Doctor may prescribe few medications which target chemicals in your brain (neurotransmitters) that affect muscle movement.

Therapy

• Physical therapy or occupational therapy or both to help ease symptoms and improve function
• Speech therapy if dystonia affects your voice
• Stretching or massage to ease muscle pain

Surgery

If your symptoms are severe, your doctor might recommend:

Deep brain stimulation. Electrodes are surgically implanted into a specific part of your brain and connected to a generator implanted in your chest. The generator sends electrical pulses to your brain that might help control your muscle contractions. The settings on the generator can be adjusted to treat your specific condition.

Selective denervation surgery. This procedure, which involves cutting the nerves that control muscle spasms, might be an option to treat some types of dystonia that haven't been successfully treated using other therapies.

Frequently asked questions

Q.What triggers dystonia?

Some causes of acquired dystonia include birth injury (including hypoxia, a lack of oxygen to the brain, and neonatal brain hemorrhage), certain infections, reactions to certain drugs, heavy metal or carbon monoxide poisoning, trauma, or stroke.

Q.How long can you live with dystonia?

In the overwhelming majority of people with dystonia, it does not shorten life expectancy or result in death. In very severe generalized dystonia that affects many body areas, there can be problems that arise secondary to the dystonia that may cause life-threatening conditions.

Q.Does exercise help dystonia?

Exercise therapy can help to manage dystonia. While exercise doesn't treat the dystonia itself, it does help to alleviate the symptoms. Symptoms which are positively affected by exercise include poor balance, rigid or poor posture, reduced mobility, and low stamina.

Q.Can you recover from dystonia?

Focal dystonia usually progresses gradually over a period of about five years and then doesn't get any worse. Sometimes, a person's symptoms improve or disappear completely.

Q.Does dystonia show on MRI?

Brains with Dystonia disease appear normal under a CT scan; however, the scan may reveal other conditions. Magnetic resonance imaging (MRI) uses magnetic fields and radio-frequency waves to create a detailed image of the brain. This test can be used to identify other conditions such as stroke or tumors in the brain.

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