Dystonia is a complex movement disorder and may affect many different parts of the body. The first symptoms of dystonia are often very mild and easily missed or mistaken for other conditions – muscle spasms, stiff muscles, stress, etc. The symptoms of dystonia are intermittent – they come and go. A muscle spasm or tremor may last several minutes or several hours. A muscle that continues to spasm or tremor repeatedly over several days or weeks indicates a more significant problem. Many people find that symptoms are exacerbated by stress, prolonged physical exertion, and fatigue.
For most people with dystonia, the level of muscle tension or tremor, the number of muscle groups affected, and the level of pain increases over time. For some individuals, the progression of the condition is gradual, with symptoms steadily becoming worse over time. Other patients may experience periods of constancy where their symptoms plateau for an extended period between changes.
Common early symptoms of dystonia include:
Eye irritation, blinking rapidly and without control, or spasms causing the eyes to close without control. Most eye irritation and muscle spasms will go away naturally within a few hours. If these conditions persist for an extended period of time, consult your physician. These may be symptoms of Blepharospasm/Focal Dystonia. If possible, it may be helpful to take a video of the issue you are experiencing to share with your physician in case the symptoms do not occur during your doctor’s appointment.
Muscle spasms in the face/cheeks, tremor during speech or changes in the way your voice sounds, or difficulty swallowing or chewing. All of us occasionally swallow incorrectly, have a wobbly voice when we speak, or get a muscle cramp. If you begin to experience these events on a frequent basis and the symptoms don’t go away, consult your physician. These may be symptoms of Cranial, Oromandibular, or Spasmodic/Laryngeal Dystonia.
Cramping of the hand muscles during or after writing, neck muscles turning or pulling to the side involuntarily, a foot that cramps or drags/turns when exercising or at random times throughout your day – these are all muscle spasms that are early indicators of dystonia if they occur regularly. Document the muscle spasms with a video if possible and schedule an appointment with your physician.
Musicians repeat the same unique movements consistently, and this may result in a class of symptoms unique to this profession. Loss of control in hand movement required for playing the piano or guitar and the inability to create the embouchure muscle when playing brass or woodwind instruments are symptoms of this condition. Similar to the muscle spasms listed above, track the timeline for your symptoms. If the symptoms last a few days then go away, return to normal activities. If the symptoms persist over an extended period of time, consult your physician.
Long-term of dystonia include:
Tremors and muscle spasms result in the inability to control the movement of muscles. This may mean a muscle group becomes “frozen” in a position and is difficult to move. It may also result in sudden movements that are not anticipated or controlled by the individual with dystonia.
The various forms of dystonia are not typically associated with pain. However, as muscles continue to contract over time, they may become painful. Think of the example where a professor holds a glass of water and asks the class how much it weighs. At the beginning of class, it is a very manageable weight. If the professor holds the glass in the same position for half the class, the arm will become fatigued. By the end of class, the arm will begin to cramp. Imagine holding the glass in the same position for weeks or months – that is what happens with muscle contractures. The muscle is constantly working; it never relaxes. Eventually, this causes pain.
Constant muscle spasms and tremors in the limbs, torso, or neck puts strain on joints. Uncontrolled muscle movements may cause joints to move in directions or at speeds that are not ideal. All of these things eventually result in deterioration of the joints. This could result in the onset of arthritis or other conditions related to the joints.
Some people experience dystonia symptoms in a single area of the body or muscle group while others experience symptoms in multiple areas of the body. The symptoms of dystonia range from mildly irritating to substantially debilitating. If the symptoms you or a loved one experience persist over an extended period, consult a physician. You can find additional information about dystonia symptoms at:
American Association of Neurological Surgeons: Patients – Neurosurgical Treatments and Conditions – DystoniaNational Institute of Neurological Disorders and Strokes: Dystonia Fact SheetNational Organization for Rare Disorders –Rare Disease Information – Dystonia
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