Overview

Dystonia is a movement disorder that causes the muscles to contract involuntarily. This can cause 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 daily tasks.

There's no cure for dystonia, but medications and therapy can improve symptoms. Surgery is sometimes used to disable or regulate nerves or certain brain regions in people with severe dystonia.

Symptoms

Dystonia affects different people in different ways. Muscle spasms might:

  • 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. It tends to remain focal or become segmental.
  • Occur during a specific action, such as writing by hand.
  • Worsen with stress, fatigue or anxiety.
  • Become more noticeable over time.

Areas of the body that can be affected include:

  • 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 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, reading, watching TV, under stress or interacting with people. Your eyes might feel dry, gritty or sensitive to light.
  • 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 blepharospasm.
  • Voice box and vocal cords (laryngeal 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). Symptoms usually don't happen when your arm is at rest.

When to see a doctor

Early signs of dystonia often are mild, occasional and linked to a specific activity. See your health care provider if you're having involuntary muscle contractions.

Causes

The exact cause of dystonia isn't known. But it might involve changes in communication between nerve cells in several regions of the brain. Some forms of dystonia are passed down in families.

Dystonia can also be a symptom of another disease or condition, including:

  • Parkinson's disease
  • Huntington's disease
  • Wilson's disease
  • Traumatic brain injury
  • Birth injury
  • Stroke
  • Brain tumor or certain disorders that develop in some people with cancer (paraneoplastic syndromes)
  • Oxygen deprivation or carbon monoxide poisoning
  • Infections, such as tuberculosis or encephalitis
  • Reactions to certain medications or heavy metal poisoning

Complications

Depending on the type of dystonia, complications can include:

  • Physical disabilities that affect your performance of daily activities or specific tasks
  • Difficulty with vision that affects your eyelids
  • Difficulty with jaw movement, swallowing or speech
  • Pain and fatigue, due to constant contraction of your muscles
  • Depression, anxiety and social withdrawal

Dystonia care at Mayo Clinic

June 18, 2022
  1. Deik A, et al. Etiology, clinical features, and diagnostic evaluation of dystonia. https://www.uptodate.com/contents/search. Accessed April 22, 2022.
  2. Flint PW, ed. Neurologic disorders of the larynx. In: Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed April 22, 2022.
  3. Batla A. Dystonia: A review. Neurology India. 2018; doi:10.4103/0028-3886.226439.
  4. Deik A, et al. Treatment of dystonia in children and adults. https://www.uptodate.com/contents/home. Accessed April 22, 2022.
  5. Frontera WR, et al., eds. Cervical dystonia. In: Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed April 22, 2022.
  6. Jankovic J, et al., eds. Parkinson disease and other movement disorders. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 22, 2022.
  7. Hongying M, et al. Blepharospasm, oromandibular dystonia, and Meige syndrome: Clinical and genetic update. Frontiers in Neurology. 2021; doi:10.3389/fneur.2021.630221.
  8. AskMayoExpert. Cervical dystonia. Mayo Clinic; 2022.
  9. Ferri FF. Dystonia. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 22, 2022.
  10. Balint B, et al. Dystonia. Nature Reviews Disease Primers. 2018; doi:10.1038/s41572-018-0023-6.
  11. Dystonias fact sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Dystonias-Fact-Sheet?TRILIBIS_EMULATOR_UA=nsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr. Accessed April 22, 2022.
  12. Dietz N, et al. Neuromodulation: Deep brain stimulation for treatment of dystonia. Neurosurgery Clinics of North America. 2019; doi:10.1016/j.nec.2018.12.001.
  13. Yoga. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/yoga. Accessed April 22, 2022.
  14. Meditation. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/meditation-in-depth. Accessed April 27, 2022.
  15. Braswell-Pickering EA. Allscripts EPSi. Mayo Clinic. Jan. 28, 2022.
  16. Bower JH (expert opinion). Mayo Clinic. May 25, 2022.