Dystonia


Dystonia
When dystonia is a group of movement disorders, neurological origin in the motor centers is located in the brain. It is expected to extrapyramidal hyperkinesias. In most cases, dystonia expressed in tension and poor posture, such as the head (torticollis). The therapy is used include botulinum toxin.

The described dystonia has nothing to do with the autonomic dystonia.

Types of dystonia
The dystonias include athetosis, tremor, and chorea Ballismus. Distinguish one can also affected by degree of spread between focal (only one region of the body), segmental (more than one body region affected) and generalized (affecting the whole body) dystonia. Furthermore, a distinction is made between primary dystonia with no obvious cause (including all hereditary dystonia) or secondary dystonia with certain causes (eg severe injury).

Examples
* The cervical dystonia or spasmodic torticollis, which manifests itself in a posture of the head.
* The blepharospasm, also known as blepharospasm or Blinzeltic that leads to uncontrollable blinking. In severe cases, subjects are virtually blind.
* The oromandibuläre dystonia, which affects the mouth and the masticatory apparatus. Concerned it is hard to eat.
* The spasmodic dysphonia, the spasms of the voice called. Affected breathy or pressed to speak and be understood any more.
* The members of dystonia, which can act as writer's cramp, cramp or musician Fußdystonie. In all cases it leads to a spasm of the limbs, which makes people unable to write, make music or to leave.
* The Segawa syndrome, which is characterized by anomalies in the position of the legs and is caused by a genetic defect on chromosome 14.

Dystonias are not affected by the compressible. Often, though, there is the phenomenon of a geste antagonist, in which, for example, tapping on the chin or touching the skin alleviates the symptoms.

The cause of dystonia is a disorder of regulation of the unconscious motor activity in the basal ganglia in the brain. Especially the internal globus pallidus seems to play a role (see Parkinson's disease). In most cases, no genetic correlations are observed. In hemifacial spasm the facial nerve is confined within the skull by an arterial loop.

Diagnostic short-lasting dystonia are frequently confused easily with tics. The latter describe the person concerned a kind of tension that forces them to execute a movement that can be short term but also suppressed.

Therapy
The sessions are held with a limited extension of the dystonia often by local injections of botulinum toxin (usually serotype A). The effect is gradually after three to seven days and reached its peak after three weeks. The injections must be repeated each at intervals of weeks to months, with decreases in some patients the effect. In this case, the dose may be switched to a certain limit or increase in serotype second Resistance in advanced or extended dystonia is the maximum administrable dose of therapy is a limit, a possible side effect is dry mouth, for example.

Other drugs, which find therapeutic use, are anticholinergics. The elimination of the affected muscles may also be operational by the appropriate - but later renewable - nerve fibers are severed. In the testing is currently the method of deep brain stimulation. These regions of the brain are electrically stimulated by an implant, which can improve the movement.

See also Epilepsy

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