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Treatments and drugs
By Mayo Clinic staffDystonia treatment has improved in recent years, due to successes with botulinum toxin injections. For more disabling cases, deep brain stimulation is now being considered.
Oral medications
Some forms of early-onset dystonia respond to levodopa — a medication that increases the effect of dopamine, a neurotransmitter involved with muscle movement. Dystonia prescriptions that act on other neurotransmitters include:
- Procyclidine hydrochloride (Kemadrin)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Clonazepam (Klonopin)
- Baclofen (Kemstro)
Sensory trick
A common phenomenon associated with dystonia is called a sensory trick. Touching an affected or adjacent body part can sometimes significantly reduce contractions. For example, placing a hand on the chin, side of the face or back of the head may reduce neck muscle contractions.
People with dystonia typically discover and use this trick to reduce their own dystonic contractions. Some physical therapists have developed head or neck braces, hand splints or other devices that mimic the sensory trick.
Botulinum toxin
Botulinum toxin (Botox, Myobloc) blocks the release of a chemical messenger that triggers muscle contractions. When your doctor injects the toxin into a muscle, it causes that muscle to temporarily weaken, which may reduce or eliminate dystonia contractions. The effect wears off, and injections need to be repeated about every three months.
Deep brain stimulation
This technique involves implanting an electrode in the brain and a stimulating device, connected to the electrode, in the chest. The stimulator generates electrical pulses, transmitted via the electrode implanted into a specific brain region that reduces the abnormal muscle contractions. To modulate the effect of the treatment, your doctor can adjust the frequency and intensity of electrical pulses.
Surgery
Surgery is considered only in severe cases of dystonia, when nothing else has worked. Surgeons can sever or remove the nerves controlling the contracted muscle, although there is a risk of disfigurement. In cases where dystonia affects a large percentage of the body, it may help to surgically destroy a portion of the thalamus — a part of the brain that helps control movement.
