Diagnosis

To diagnose dystonia, your doctor will start with a medical history and physical examination.

To determine if underlying conditions are causing your symptoms, your doctor might recommend:

  • 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.

Treatment

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

Medications

Injections of onabotulinumtoxinA (Botox) 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.

Other medications target chemicals in your brain (neurotransmitters) that affect muscle movement. The options include:

  • Carbidopa-levodopa (Duopa, Rytary, others). This medication can increase levels of the neurotransmitter dopamine.
  • Trihexyphenidyl and benztropine (Cogentin). These medications act on neurotransmitters other than dopamine. Side effects can include memory loss, blurred vision, drowsiness, dry mouth and constipation.
  • Tetrabenazine (Austedo, Xenazine). This medication blocks dopamine. Side effects can include sedation, nervousness, depression or insomnia.
  • Diazepam (Valium), clonazepam (Klonopin) and baclofen (Lioresal, Gablofen). These medications reduce neurotransmission and might help some forms of dystonia. They may cause side effects, such as drowsiness.

Therapy

Your doctor might suggest:

  • 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.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

Dystonia has no cure, but you can do a number of things to minimize its effects:

  • Sensory tricks to reduce spasms. Touching certain parts of your body may cause spasms to stop temporarily.
  • Heat or cold. Applying heat or cold can help ease muscle pain.
  • Stress management. Learn effective coping skills to manage stress, such as deep breathing, social support and positive self-talk.

Alternative medicine

Alternative treatments for dystonia haven't been well-studied. Ask your doctor about complementary treatments before you start. Consider:

  • Meditation and deep breathing. Both might ease stress that can worsen spasms.
  • Biofeedback. A therapist uses electronic devices to monitor your body's functions, such as muscle tension, heart rate and blood pressure. You then learn how to control your body responses, which might help reduce muscle tension and stress.
  • Yoga. Yoga combines physical postures, breathing techniques, and meditation or relaxation.

Coping and support

Living with dystonia can be difficult and frustrating. Your body might not always move as you would like, and you may be uncomfortable in social situations. You and your family might find it helpful to talk to a therapist or join a support group.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the nervous system (neurologist).

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
  • Make a list of all your medications, vitamins and supplements.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Write down questions to ask your doctor.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.

Questions to ask your doctor

  • What's the most likely cause of my symptoms?
  • What kinds of tests do I need? Do they require any special preparation?
  • Is my condition likely temporary or chronic?
  • What treatments are available?
  • What side effects can I expect from these treatments?
  • I have these other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may make time to go over points you want to spend more time on. You may be asked:

  • When did you begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has anyone in your family ever been diagnosed with dystonia?

Dystonia care at Mayo Clinic

Aug. 10, 2018
References
  1. Comella C. Classification and evaluation of dystonia. http://www.uptodate.com/home. Accessed Sept. 30, 2015.
  2. Flint PW, ed. Neurologic disorders of the larynx. In: Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 30, 2015.
  3. Jinnah HA, et al. Diagnosis and treatment of dystonia. Neurologic Clinics. 2015;33:77.
  4. Comella C. Treatment of dystonia. http://www.uptodate.com/home. Accessed Sept. 30, 2015.
  5. Frontera WR, et al., eds. Cervical dystonia. In: Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed Sept. 30, 2015.
  6. Yanoff M, et al., eds. Essential blepharospasm. In: Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier;; 2014. http://www.clinicalkey.com. Accessed Sept. 30, 2015.
  7. Khan J, et al. Oromandibular dystonia: Differential diagnosis and management. Journal of the American Dental Association. 2015;146:690.
  8. AskMayoExpert. Cervical dystonia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  9. Ferri FF. Neurology. In: Ferri's Practical Guide: Fast Facts for Patient Care. 9th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Sept. 30, 2015.
  10. Prudenta CN, et al. Dystonia as a network disorder: What is the role of the cerebellum? Neuroscience. 2014;260:23.
  11. Dystonias fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm. Accessed Sept. 30, 2015.
  12. Mills KA, et al. Neuromodulation for dystonia: Target and patient selection. Neurosurgery Clinics of North America. 2014;25:59.
  13. Yoga. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/yoga. Accessed Sept. 30, 2015.
  14. Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 12, 2018.
  15. Bellamkonda E (expert opinion). Mayo Clinic, Rochester, Minn. May 18, 2018.