DYSTONIA: May twist our muscles but it can't twist our hearts

Dr Pranjal Gogoi

(The writer is a senior physiotherapist. He can be reached at pranjal_gogoi25@rediffmail.com)

Agentleman visited to his friend's house for a dinner party and perhaps got noticed by his friend of his unusual head movement. That was an instant always the same question comes "Are you okay?" And always the same lie "I'm fine."

It's Dystonia, a neurological movement disorder that affects the nervous system which is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements, postures, or both. It may emerge at any age, not gender specific, may remain static or may progress, may occur in isolation or may combined with other medical condition. Common symptoms of Dystonia are involuntary neck movement, eye blinking rapidly and uncontrollably, tendency of foot being turned and dragged after walking a while, worsening of handwriting after writing a few lines and sometimes tremor or difficulty in speaking. Dystonia is classified into Generalized Dystonia, Focal Dystonia, Multifocal Dystonia, Segmental Dystonia and Hemi Dystonia.

A multimodal treatment approach is required which entirely depends upon the type and its severity. The botulinum toxin, also called Botox or Xeomin injection, Deep brain stimulation, Medication, Physiotherapy include movement practice, strengthening exercises, postural re-education, sensory reorganization, sensory motor rehabilitation, conditioning exercises and pain management play a crucial role in the treatment. The involvement of speech requires speech therapy. The Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH) which is the Federal agency with primary responsibility for brain and neuromuscular research sponsoring research with ultimate goals to find the cause of the Dystonias so that they can be prevented, and to find ways to cure or more effectively treat people who are affected.

Dystonia can be treated if the individual identifies and develops awareness at right time and seek specific medical treatment. Apart from medical management a Dystonia patient needs to develop confidence within him and minimize the mental stress.