Focal dystonia is a neurological disorder that causes involuntary spasms of small muscles in the body. It is a rare condition sometimes referred to as “the yips”. It occurs from repetitive stress or overuse, and it usually affects musicians and golfers.
Fingers are prone to curling into the palm or extending outward without control if the disorder affects the hands.
Focal dystonia is a relatively common neurological disorder, though it’s a relatively rare condition. Approximately 30 people out of every 100,000 have the disorder in the United States.
Children can also be afflicted by this condition, though its symptoms begin most commonly between 40 and 60 years of age.
Our aim in this article is to analyze the different types, symptoms, possible causes, and treatment options for focal dystonia.
Read: Generalized Dystonia
Difference between focal dystonia and carpal tunnel syndrome
Carpal tunnel syndrome and focal dystonia can have similar symptoms. The problem with focal dystonia is that your brain and nerves aren’t communicating correctly. Overuse or nerve problems can cause carpal tunnel syndrome.
Types
An individual with dystonia suffers from a variety of movement problems. Dystonia affects various parts of the body with various types. Dystonia that develops in only one area is considered focal dystonia.
This type of dystonia usually develops in adults.
Likewise, focal dystonia comes in a variety of types, depending on the body part that it affects. Here are some examples:
- Focal hand dystonia: When practicing highly repetitive or practiced hand motions, this type of focal dystonia often causes cramps, tremors, or involuntary movements in the hand. It is sometimes called “writer’s cramp” or “musician’s cramp” when caused by writing or playing an instrument. The term “task-specific dystonia” may also be used.
- Foot dystonia: Muscles in the foot may contract due to incorrect signals from the brain.
- Tardive dystonia: When people take medications to treat other conditions, they may develop this form of dystonia.
- Paroxysmal dystonia: An uncommon form of dystonia, occurring in short episodes and causing no observable symptoms outside of these episodes.
- Voice and laryngeal dystonia: In this case, the individual suffers from uncontrollable spasms of the vocal cords. This affects the voice’s quality.
- Neck or cervical dystonia: An injury to the neck can cause muscle contractions that can cause pain and result in an uneasy posture, such as pulling the head forward, backward, or to one side.
- Blepharospasm: It is possible for dystonia to affect the area around the eye, resulting in the involuntary closing of the eyes.
Dystonias of several types can occur. There are three distinct categories of dystonias. These are caused by onset age and area of development.
Read: Chronic Motor Tic Disorder
Focal dystonia symptoms
There are different types of dystonia.
Loss of muscle coordination may be one of the early symptoms.
It might be difficult for the individual to use a pen at first. It is possible that they suffer small injuries to the hand on a regular basis and might drop items more often.
It is possible to experience trembling and cramping pain after repeatedly using a muscle.
When holding a book and turning its pages, you may experience intense muscle pain and cramping.
People may experience additional symptoms on a continuous basis related to their muscles and their brain activity, such as:
- Sleep disturbances
- Exhaustion
- Mood swings
- Mental stress
- Difficulty concentrating
- Blurred vision
- Digestive problems
- Short temper
It is possible to experience depression in people who have dystonia. Their daily activities may become more difficult as the condition worsens.
It’s common for symptoms to get worse before stabilizing. It’s also possible for symptoms to stop progressing altogether.
Lifestyle changes and treatment can slow down the development of focal dystonia. A person may experience rapidly worsening symptoms if they continue using their muscles as before.
Read: Motor Disorders
Focal dystonia causes
Some cases of this disorder are hereditary, but others are not.
Brain chemicals called neurotransmitters send messages from one part of the brain to another. The basal ganglia can become dystonic if there is a shortage or malfunction of such chemicals.
There’s a bunch of brain cells in the basal ganglia at the front of your brain. The brain sends messages to these muscles, enabling them to move.
Dystonia secondary to another neurological condition or an environmental factor might cause secondary dystonia. It is possible for dystonia to result from birth injuries, oxygen deprivation or neonatal brain hemorrhage.
Trauma and stroke may also cause dystonia later in life.
An infection and certain exposures may also trigger dystonia. There are some medications that block dopamine, heavy metals, and carbon monoxide among them.
The chances of developing a disorder are higher among musicians, engineers, architects, and artists who use their hands to perform high-precision actions.
In addition, it is often “task-specific,” meaning that it only arises when performing a particular activity.
Stressful competitions and performances may cause athletes and musicians to experience anxiety.
It’s possible to get secondary focal dystonia if you have a neurological condition already, like Parkinson’s or Huntington’s.
Parkinson’s is caused by insufficient dopamine, a neurotransmitter that gives people a feeling of well-being, whereas Huntington’s is caused by a lack of cholesterol in the brain. There is a genetic condition called Wilson’s disease, in which copper builds up in the body’s tissues.
These disorders also affect the nervous system, so people with multiple sclerosis (MS) and cerebral palsy might also get the yips.
Read: Facial Tics Disorder
Focal dystonia diagnosis
There are various treatment options depending on the cause. It is therefore important for the doctor to first establish if a patient’s dystonia is primary or secondary.
Electrical sensors are used in electromyography (EMG) to provide a diagnosis. Doctors insert electrodes into the relevant muscles to provide a diagnosis.
When the muscles are at rest, pulsating nerve signals are transmitted to them.
A person suffering from focal dystonia will find that the muscles fatigue very quickly, and some parts of the muscles will not respond, resulting in weakness. Other parts of the muscles may become rigid or overreact.
More severe focal dystonia can be detected with this test, but it can be painful.
Read: Capgras Syndrome
Focal dystonia treatment
Changes in lifestyle can decrease the types of movement that trigger or exacerbate dystonic symptoms.
Moderate exercise may also be beneficial, as well as reducing stress. Meditation, yoga, and tai chi are relaxation techniques that may alleviate symptoms as well.
Botox: Dystonia cannot be cured by Botox injections, however, they can ease some of the symptoms. Doctors inject botulinum toxin directly into the affected muscles with Botox, a commercially prepared form of the toxin.
Neurotransmitters involved in muscle spasms cannot reach the spasming muscles due to a protein in this protein. An additional injection usually needs to be given after 3 months.
Clonazepam: It’s an anti-seizure medicine that doctors prescribe sometimes. The drug does not significantly alter mental status, but adverse reactions such as sedation, mood swings, and short-term memory loss can occur.
Anticholinergics: People with certain types of focal dystonia can benefit from this class of medication. Acetylcholine is a neurotransmitter that the drugs block. People with dystonia may experience muscle spasms when they consume acetylcholine.
Dystonia has been linked to cannabidiol (CBD), one of the nonpsychoactive compounds present in Cannabis sativa, and some people have proposed that it might be useful for treating the disorder.
Currently, more research is needed to understand its effects. The risk of cannabis use disorders needs to be taken into account when determining whether CBD can be appropriately used to treat movement disorders.
Patients suffering from secondary focal dystonia may have their symptoms reduced by treating an underlying condition, such as Parkinson’s.
Read: Confabulation
How can I prevent focal dystonia?
Experts do not know what causes focal dystonia. Therefore, no prevention can be guaranteed. Focal dystonia is worsened by certain factors. The following may be helpful:
- Be careful not to overdo the talking or movements
- Cope with stress in a healthy way
- Sleep well, exercise regularly, and eat healthy to reduce fatigue
Future prospects
It is rare for dystonia to remit or improve, and the condition is commonly lifelong. The condition lives a normal lifespan, but the symptoms are persistent.
People with the condition may have to restrict certain activities due to ongoing symptoms.
Healthcare professionals can provide dystonia patients with pain relief and help them modify their posture and movements as they learn how to live with this condition.
Bottom line
An involuntary muscle contraction in one part of the body is known as focal dystonia. It is common for people who use fine motor skills frequently to suffer from focal dystonia that affects their hands, wrists, and arms. People with this disorder are often musicians, athletes, hairstylists, and writers.
There are similarities between focal dystonia and nerve injuries. Focal dystonia occurs when muscle, nerve, and brain communication become misaligned. An individual may be treated by changing their lifestyle, taking medication, getting injections, or undergoing surgery.
