Dystonia

Motive at which there is a spasmodic or continuous reduction of muscles forcing the patient to accept violently pathological poses and to reproduce the uncontrollable movements call dystonia.

Disturbance of interaction between activation and relaxation of muscles because of what there is an uncontrollable and involuntary reduction, both separate muscles, and the whole groups acts as a cause of illness.

The modern medicine cannot answer yet a question why there is a disturbance of this interaction therefore unambiguously it is impossible to tell about dystonia syndrome origins. The disease has no specific electrophysiologic, biochemical, pathomorphologic and other diagnostic markers.

According to statistical data, about 1% of all world's population suffers from a syndrome of dystonia. And at women the disease meets many times more often, than at men.

Dystonia forms

Etiological classification of a disease is not up to the end developed presently, generally it includes 4 sections, however in some sources it is possible to meet still the fifth form of a disease – pseudo-dystonia. Understand the syndrome arising against the background of diseases which can remind dystonia, however, in fact, it not being (Sandifer's syndrome, Isaaksa, etc.) as it

Allocate primary and secondary dystonias – the first is not connected with other neurologic deviations, the second develops against the background of damage of tissue of head and spinal cord, peripheral nerves and as a result of influence of external environment.

Primary dystonia can be shown both at children's age, and in mature, it represents group of hereditary diseases which can be transmitted on autosomal recessively, autosomal dominantly or to the H-linked mode of inheritance and to be combined with a tremor, parkinsonism or a moikloniya.

Secondary dystonia can arise owing to hereditary metabolic diseases, at injuries, a poisoning with carbon monoxide, a stroke or a subdural hematoma.

On the basis of prevalence in medicine allocate the following forms of a syndrome of dystonia:

• Segmented – at which symptoms of dystonia are observed in two adjacent parts of a body;
• Focal – the disease is observed in any one part of a body, it is designated on the area struck with a syndrome (cranial, axial, cervical, etc.);
• Generalized – at which the patient has an opportunity to weaken the involuntary movements by corrective gestures;
• Gemidistoniya – manifestation of the syndrome consisting of kruralny and brachial dystonia on one half of a body;
• Multifocal – at this form of dystonia symptoms are distributed in two and any more adjacent each other parts of a body.

In turn focal dystonia is subdivided into the following forms:

• Cervical;
• Nictitating spasm;
• Kruralny;
• Writer's cramp;
• Oromandibulyarny;
• Spastic.

On an etymological sign allocate such form of a disease as Dystonia plus which is understood as association of group of the diseases which are not relating to primary and secondary forms.

Dystonia symptoms

Clinical manifestations of a syndrome depend on a disease etiology. So symptoms of dystonia, depending on the place of defeat, are:

• Feet – the expressed bending of toes, extension and podvorachivany extremities;
• Brushes – bending with overextension of fingers;
• Neck and trunk – rotary motions;
• Front area – protrusion of language, a zazhmurivaniye of eyes, the forced closing or opening of a mouth, a pulling of lips.

Symptoms of dystonia are also states at which the patient accepts unnatural disabling poses. In all cases these manifestations completely disappear at relaxation and during sleep.

Diagnosis of dystonia

It is possible to diagnose primary form of a disease only clinically, it is possible to distinguish symptoms of dystonia secondary only after carrying out according to indications of a wide range of researches.

In many cases genetic inspections, cytologic and biochemical analysis of a bioptat of fabrics, biochemical researches and other paraclinic diagnostic methods are required.

Also detailed poll of the patient from the attending physician as it considerably increases chances of adequate clinical diagnosis of a disease is required.

Treatment of dystonia

At a disease apply drug or surgical treatment. Originally in hospital check reaction of an organism to treatment of dystonia the Levodopa or agonists of dopamine receptors. If it negative, apply cholinolytics, Carbamazepine, Baclofenum and benzodiazepines with long action.

Trial treatment by various medicines has to be carried out systematically for exact definition whether such therapy renders the necessary effect. Use of trial drug treatment of dystonia at children's age has to last not less than half a year as the therapeutic effect at this group of patients can be shown not at once.

Surgical treatment of dystonia represents carrying out a stereotaxic talamotomiya or pallidotomiya which are applied only in the most hard cases. Focal dystonia treat by means of local introduction to the muscles involved in a hyperkinesia, botulotoxin everyone two or four months. Side effects at this type of treatment are minimized.

Understand motive neurologic frustration because of which there are spasmodic or continuous reductions of muscles forcing the person to accept unnatural poses and to reproduce the uncontrollable movements by various parts of a body as dystonia. The disease demands careful clinical diagnosis with carrying out a number of analyses and researches, and also purposes of adequate drug or surgical treatment.