Definition

Focal dystonia (FD) is a movement problem that happens in one part of the body. You may have unusual movements, twitches, and tics. It may happen all the time or off and on. The most common types are:

  • Blepharospasm—an eye twitch
  • Cervical dystonia or spasmodic torticollis—happens to the neck
  • Segmental cranial dystonia, also known as Meige syndrome—happens to the jaw, tongue and eyes
  • Oromandibular dystonia—happens to the jaw
  • Spasmodic dysphonia—happens to the vocal cords
  • Axial dystonia—happens to the trunk
  • Dystonia of the hand/arm, such as writer's cramp

Causes

In many cases, the cause of FD is not known. In others, it may be due to genes.

FD can also be caused by a health problem, injury, or your genes. This is called secondary FD.

It may be due to:

The Process of Carbon Monoxide Poisoning Decreasing Available Oxygen

Carbon monoxide poisoning
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Risk Factors

Having people in your family with FD raises your risk of getting it.

Having a health problem, injury, or certain genes also raises your chance of getting secondary FD.

Symptoms

Symptoms may include:

  • Eyelid spasms
  • Rapid or uncontrollable blinking of both eyes
  • Neck twisting
  • A hard time writing
  • Foot cramps
  • Pulling or dragging of a foot
  • Shaking
  • Problems speaking

FD may get worse with:

  • Excitement
  • Stress
  • Talking
  • Being tired

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done. You may need a neurologic exam and an eye exam. You may be sent to a speech-language pathologist, physical or occupational therapists, and genetic counselors.

You may have:

The electrical activity of your muscles, nerves, and brain may need to be measured. This can be done with:

Pictures may need to be taken of your head. This can be done with:

Electroencephalography

EEG
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Treatment

Talk with your doctor about the best plan for you. You may have:

Your doctor may advise one or more medicines:

  • Over the counter or prescription pain medicine
  • Anticholinergics
  • Benzodiazepines
  • Dopaminergic agents
  • Dopamine-depleting agents
  • Antiseizure medicine

Injecting botulinum toxin into a muscle can weaken the muscle. This may help you feel better for 3-4 months.

Surgery to cut the nerves leading to muscles or removing the muscles may help. Also, surgery to destroy the small site within the brain where dystonia occurs may stop or ease FD.

Deep brain stimulation may also help.

Prevention

FD can’t be prevented. If you take any medicines that may cause FD, talk with your doctor about your risk of getting FD.