Is dystonia a form of Parkinson's?

Dystonia can be a symptom of Parkinson's disease.
Dystonia can be a symptom of Parkinson's disease.

Dystonia can be one of the symptoms of Parkinson’s disease (PD). PD is a long-term neurological movement disorder with various symptoms ranging from slowness of movement (bradykinesia), rigidity of muscles, tremor, loss of balance, memory impairment, personality changes and others. In young-onset PD, foot dystonia may be the first feature. Later, other symptoms such as personality changes and memory impairment become noticeable. 

Dystonia may sometimes develop as an isolated symptom in individuals who do not have PD. It may be seen in people who suffer from Huntington’s chorea, birth injury, stroke, brain infections, etc. Sometimes, a person with Parkinson’s may develop dystonia due to the drug Leva Dopa that is given as a part of PD treatment.

Dystonia is a neurological disorder that purely affects movement and is characterized by involuntary (not under conscious control) contractions of the muscles causing repetitive or twisting movements or abnormal postures. Dystonia can occur in isolation or as a symptom of PD. It, however, does not affect everyone with PD.

Both PD and dystonia seem to occur due to the involvement of a part of the brain called the basal ganglia. Thus, the symptoms of both can occur in the same person.

What is dystonia?

Dystonia is a neurological disorder characterized by involuntary (not under conscious control) contractions of the muscles causing repetitive or twisting movements or abnormal postures. Movements in dystonia may be painful, interfering with everyday tasks. Besides the involuntary movements, some people with dystonia may have tremors or other neurologic features. Dystonia is one of the most common movement disorders affecting around 250,000 people in the United States. Dystonia can affect any part of the body including the face, jaw, eyelids, neck, torso or limbs. Dystonia has different names depending on which parts  of the body are affected

  • Generalized dystonia: This affects most or all of the body.
  • Focal dystonia: This type of dystonia is localized to a specific part of the body.
  • Multifocal dystonia: This affects two or more unrelated body parts.
  • Segmental dystonia: This involves two or more adjacent parts of the body.
  • Hemidystonia: In this type of dystonia, the arm and leg on the same side of the body are involved.

What are the symptoms of dystonia?

The symptoms of dystonia may vary from person to person. Various types of dystonia can affect only one muscle, groups of muscles or muscles throughout the body. In childhood or early-onset dystonia, the symptoms often start in the limbs and may progress to involve other parts of the body. Symptoms may occur after periods of exertion. They may fluctuate throughout the course of the day.

In adult-onset dystonia, the symptoms usually affect one or adjacent parts of the body, most often involving the neck and/or facial muscles.

Involuntary muscle contractions may affect a single area (focal dystonia) such as the leg, jaw or arm.

  • Symptoms may occur while performing a specific task such as playing a musical instrument (musician’s dystonia), typing (typist’s cramp) or writing (writer’s cramp). These are called task-specific dystonia. 
  • Dystonia symptoms may get worse because of anxiety, fatigue or stress.
  • In neck or cervical dystonia or torticollis, the neck may twist and turn to one side or pull forward or backward. This may cause pain.
  • In blepharospasm, the eyelids are affected. There is rapid blinking or involuntary spasms that close the eyes. It may be severe in the presence of bright light, stress or public interactions. There is no pain, but the eyes may feel dry.
  • Oromandibular dystonia involves the muscles of the jaw, lips and tongue. It can cause difficulties with opening and closing the jaw. It may affect speech and swallowing. There may be slurred speech, drooling and difficulty in chewing and swallowing. 
  • Laryngeal or spasmodic dystonia affects the muscles of the vocal cords. It causes strained, whispering or breathy voice. 

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Medically Reviewed on 10/7/2020
References
Medscape Medical Reference

NIH


Dystonia Medical Research Foundation Canada


American Parkinson Disease Association


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