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