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DYSTONIA


About Dystonia

Centre of Excellence for Neurosciences at Vimhans Nayati Super Speciality Hospital is offering the best care and treatment facilities for the effective management of various movement disorders including Dystonia. Marked by involuntary muscle contractions that result in repetitive movements, abnormal body postures and twisting, Dystonia affects nearly 1 percent of the world population. Although the problem can affect anyone, women have been found to be more prone to it as compared to men.

Dystonia can affect a single muscle or a group of muscles at the same time and is generally classified depending upon the area of the body that is affected or the pattern in which it occurs. The former includes Generalised Dystonia, Focal Dystonia, Multifocal Dystonia, Segmental Dystonia and Hemi Dystonia, whereas the latter include the following:

  • Blepharospasm, which affects the eyes and is marked by the involuntary closing of the eyelids or uncontrollable blinking.
  • Cervical Dystonia, which is the most common type of Dystonia. It is quite common in middle-aged people and is marked by the involuntary twisting and turning of the neck muscles
  • Cranial Dystonia, which usually affects the muscles of the face, neck and head.
  • Oromandibular Dystonia, which affects the muscles present in the jaw, lips and tongue
  • Spasmodic Dystonia, which disrupts speech
  • Writer’s cramp, which affects the hand or forearm muscles and is only experienced while writing.

Symptoms that might be an indication of Dystonia

The symptoms of Dystonia vary from one person to another. These can be mild or severe and differ depending upon the muscles that are affected and the various stages through which the problem progresses. Here are some common symptoms associated with Dystonia:

  • Muscle contractions that start in one part of the body and gradually radiate to other parts
  • Muscle spasms experienced during specific actions.
  • Muscle contractions that become worse with stress and fatigue.
  • Muscle contractions that become more severe over time.
  • Uncontrollable blinking of eyes or involuntary shutting of eyelids.
  • Involuntary pulling of the neck.
  • Pain and exhaustion due to persistent muscle contractions.

What causes Dystonia?

In most of the cases, Dystonia does not have any specific cause and is usually associated with abnormalities in basal ganglia i.e. the area of the brain that is responsible for muscle contractions and it affects the way in which the nerve cells communicate with each other. The abnormalities in the basal ganglia are a result of damage caused by any of the following:

  • Severe brain trauma suffered in an accident.
  • Stroke
  • Underlying medical conditions like Parkinson’s disease and Huntington’s disease.
  • Malignant or benign brain tumour.
  • Chronic infection involving the brain.
  • Side-effects of certain drugs.
  • Poisoning caused by toxic compounds and chemicals like lead and carbon monoxide.

Factors that increase the risks of Dystonia

There are several factors that can increase the risks of Dystonia. These are as under:

  • Genetic abnormalities or family history of Dystonia
  • Severe injury to the brain
  • History of stroke
  • Intake of certain medications
  • Underlying infections
  • Demographic factors like age and gender

State of the art diagnostic procedures offered at Vimhans Nayati Super Speciality Hospital

Certain factors that increase the risks of epilepsy include:

  • Various diagnostic procedures offered at Vimhans Nayati for detecting and assessing Dystonia are as under
  • Physical examination and evaluation of the medical history of the patient
  • Blood and urine tests to assess the concentration of toxins
  • Magnetic resonance imaging (MRI) scan and Computerized Tomography (CT) scan to detect visible abnormalities, lesions and traumas in the brain
  • Electromyography (EMG) to measure the electrical activity of the brain
  • Genetic tests for determining genetic abnormalities that may be causing Dystonia

Treatments offered by Vimhans expertise for the management of Dystonia

Cutting-edge treatment options offered at Vimhans Nayati for the treatment and management of Dystonia include:

  • Medication – Certain injections like Botox and Dysport may be given to target different muscles to reduce or completely eliminate muscle contractions and help with the posture. Apart from these, we also offer medicines to target the neurotransmitters that are responsible for the muscle spasms.
  • Therapies – These include both physical as well as speech therapies that aim at relieving the symptoms and improving the quality of the patient’s life.
  • Surgery – These include procedures like deep brain stimulation and selective denervation surgery.
    • Deep brain stimulation or DBS involves the surgical implantation of special electrodes in the brain which are connected to the pulse generator implanted in the chest cavity, with the help of wires. The generator produces and sends impulses to the brain to control the muscle contractions. The intensity of the impulses can be changed to suit the specific needs of the patient.
    • Selective Denervation involves the cutting of some nerves so as to control muscle spasms and is recommended to patients who are not responding well to medication.

Chairman Neurosciences And Director Clinical Services

Dr. Shamsher Dwivedee

MBBS, MD, DM (NEUROLOGY)

He is one of India’s most renowned neurologists with a rich experience of over 3 decades in clinical neurology.

  • Part of the team which performed the first DBS program of South East Asia.
  • In 2013 he established the Multiple Sclerosis Clinic at Vimhans.
  • He had established College of Clinical research at Vimhans. He initiated Diplomat National Board (DNB) programme in Neurology at Vimhans & PSRI.
  • Has to his credit largest number of clinical trials in India for various neurological disorders.
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Head - Neurointervention & Principal Consultant Neurosurgery

Dr. Sumit Goyal

MBBS, DNB (NEUROSURGERY), FINR (FOUNDATION ROTHSCHILD PARIS, FRANCE)

He is an accomplished neurosurgeon, with over 15 years of hands-on experience in the field. He is one of the few neurosurgeons who is also trained in neurointervention.

  • Senior Consultant, Department of Neurosurgery and Neuro-intervention at PSRI Hospital, New Delhi
  • Associate Consultant, Department of Neurosurgery Sir Ganga Ram Hospital , New Delhi
  • Assistant Professor at Ganga Ram Institute of Post Graduate Medical Education and Research (GRIPMER)
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