dystonia

Dystonia is a movement disorder that causes involuntary contractions of your muscles. These contractions result in twisting and repetitive movements. Sometimes they are painful.

Dystonia can affect just one muscle, a group of muscles or all of your muscles. Symptoms can include tremors, voice problems or a dragging foot. Symptoms often start in childhood. They can also start in the late teens or early adulthood. Some cases worsen over time. Others are mild.

Some people inherit dystonia. Others have it because of another disease. Researchers think that dystonia may be due to a problem in the part of the brain that handles messages about muscle contractions. There is no cure. Doctors use medicines, Botox injections, surgery, physical therapy, and other treatments to reduce or eliminate muscle spasms and pain.

NIH: National Institute of Neurological Disorders and Stroke

Movement disorders are neurologic conditions that cause problems with movement, such as:

• Increased movement that can be voluntary (intentional) or involuntary (unintended)
• Decreased or slow voluntary movement

There are many different movement disorders. Some of the more common types include:

• Ataxia, the loss of muscle coordination
• Dystonia, in which involuntary contractions of your muscles cause twisting and repetitive movements. The movements can be painful.
• Huntington's disease, an inherited disease that causes nerve cells in certain parts of the brain to waste away. This includes the nerve cells that help to control voluntary movement.
• Parkinson's disease, which is disorder that slowly gets worse over time. It causes tremors, slowness of movement, and trouble walking.
• Tourette syndrome, a condition which causes people to make sudden twitches, movements, or sounds (tics)
• Tremor and essential tremor, which cause involuntary trembling or shaking movements. The movements may be in one or more parts of your body.

Causes of movement disorders include:

• Genetics
• Infections
• Medicines
• Damage to the brain, spinal cord, or peripheral nerves
• Metabolic disorders
• Stroke and vascular diseases
• Toxins

Treatment varies by disorder. Medicines can cure some disorders. Others get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms and relieve pain.

A tremor is a neurological condition that includes shaking or trembling movements in one or more parts of your body. It most often affects the hands. But it can also affect the arms, legs, head, vocal cords, and torso (trunk). A tremor is involuntary, meaning that you cannot control it. It happens because of muscle contractions.

A tremor may come and go, or it may be constant. It can happen on its own or be caused by another disorder. It is not life threatening, but it may cause challenges. It can make it hard to do daily life tasks such as writing, typing, eating, and dressing. In some cases, a tremor can even lead to disabilities.

There are several types of tremor, including:

• Essential tremor, sometimes called benign essential tremor or familial tremor. This is the most common type. It usually affects both your hands and arms while you are moving them. It can also affect your head, voice, or legs.
• Parkinsonian tremor, which is a common symptom in people who have Parkinson's disease. It usually affects one or both hands when they are at rest, but it can affect the chin, lips, face, and legs.
• Dystonic tremor, which happens in people who have dystonia. Dystonia is a movement disorder in which you have involuntary muscle contractions. The contractions cause you to have twisting and repetitive movements. It can affect any muscle in the body.

Generally, tremor is caused by a problem in the deep parts of the brain that control movements. For most types, the cause is unknown. Some types are inherited and run in families. There can also be other causes, such as:

• Neurologic disorders, including multiple sclerosis, Parkinson's disease, stroke, and traumatic brain injury
• Certain medicines, such as asthma medicines, chemotherapy, corticosteroids, and medicines used for certain psychiatric and neurological disorders
• Alcohol use disorder (AUD) or alcohol withdrawal
• Poisoning from certain toxic substances, including pesticides and heavy metals such as mercury and lead
• Hyperthyroidism (overactive thyroid)
• Liver or kidney failure
• Anxiety or panic
• Too much caffeine

Anyone can get tremor, but it is most common in middle-aged and older adults. For certain types of tremor, having a family history raises your risk of getting it.

Symptoms of tremor may include:

• Rhythmic shaking in the hands, arms, head, legs, or torso
• Shaky voice
• Difficulty writing or drawing
• Problems holding and controlling utensils, such as a spoon

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, which includes checking:
  • Whether the tremor happens when the muscles are at rest or in action
  • The location of the tremor
  • How often you have the tremor and how strong it is
• A neurological exam, including checking for:
  • Problems with balance
  • Problems with speech
  • Increased muscle stiffness
• Blood or urine tests to look for the cause
• Imaging tests to help figure out if the cause is damage to your brain
• Tests that check your abilities to do daily tasks such as handwriting and holding a fork or cup
• An electromyogram, a test that measures involuntary muscle activity and how your muscles respond to nerve stimulation

There is no cure for most forms of tremor, but there are treatments to help manage symptoms. In some cases, the symptoms may be so mild that you do not need treatment.

Finding the right treatment depends on getting the right diagnosis of the cause. Tremor caused by another medical condition may get better or go away when you treat that condition. If your tremor is caused by a certain medicine, stopping that medicine usually makes the tremor go away.

Treatments for tremor can include:

• Medicines. There are different medicines for the specific types of tremor. Another option is Botox injections, which can treat several different types of tremor.
• Surgery may be used for severe cases that do not get better with medicines. The most common type is deep brain stimulation (DBS). DBS uses electrodes that are implanted in the brain. The electrodes send electrical pulses to the parts of the brain that are causing the tremor.
• Physical, speech-language, and occupational therapy, which may help to control tremor and deal with the daily challenges caused by the tremor.

If you find that caffeine and other stimulants trigger your tremors, it may be helpful to cut them from your diet.

NIH: National Institute of Neurological Disorders and Stroke

Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including:

• Temporary smoothing of facial wrinkles and improving your appearance
• Severe underarm sweating
• Cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions
• Blepharospasm - uncontrollable blinking
• Strabismus - misaligned eyes
• Chronic migraine
• Overactive bladder

Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to twelve months, depending on what you are treating. The most common side effects are pain, swelling, or bruising at the injection site. You could also have flu-like symptoms, headache, and upset stomach. Injections in the face may also cause temporary drooping eyelids. You should not use Botox if you are pregnant or breastfeeding.

No matter how old you are or what you do for a living, you are always using your hands. When there is something wrong with them, you may not be able to do your regular activities.

Hand problems include :

• Carpal tunnel syndrome - compression of a nerve as it goes through the wrist, often making your fingers feel numb
• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis, which can also cause deformity
• Tendinitis - irritation of the tendons
• Disorders and injuries of your fingers and thumb

It's frustrating to be unable to hear well enough to enjoy talking with friends or family. Hearing disorders make it hard, but not impossible, to hear. They can often be helped. Deafness can keep you from hearing sound at all.

What causes hearing loss? Some possibilities are:

• Heredity
• Diseases such as ear infections and meningitis
• Trauma
• Certain medicines
• Long-term exposure to loud noise
• Aging

There are two main types of hearing loss. One happens when your inner ear or auditory nerve is damaged. This type is usually permanent. The other kind happens when sound waves cannot reach your inner ear. Earwax buildup, fluid, or a punctured eardrum can cause it. Treatment or surgery can often reverse this kind of hearing loss.

Untreated, hearing problems can get worse. If you have trouble hearing, you can get help. Possible treatments include hearing aids, cochlear implants, special training, certain medicines, and surgery.

NIH: National Institute on Deafness and Other Communication Disorders

Your mouth is one of the most important parts of your body. It has many different functions. It allows you to:

• Take in food and drink
• Breathe in air
• Start digestion, with your teeth chewing the food you eat and your salivary glands releasing saliva to help break down the food
• Speak and sing
• Show emotion, by smiling or pouting

Any problem that affects your mouth can make it hard to eat, drink, or even smile. Some common mouth problems include:

• Cold sores - painful sores on the lips and around the mouth, caused by a virus
• Canker sores - painful sores in the mouth, caused by bacteria or viruses
• Thrush - a yeast infection that causes white patches in your mouth
• Leukoplakia - white patches of excess cell growth on the cheeks, gums or tongue, common in smokers
• Dry mouth - a lack of enough saliva, caused by some medicines and certain diseases
• Gum or tooth problems
• Bad breath

Treatment for mouth disorders varies, depending on the problem. If a mouth problem is caused by some other disease, treating that disease can help. It is also important to keep your mouth clean and healthy by brushing, flossing, and not using tobacco.

Any part of your neck - muscles, bones, joints, tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from your shoulder, jaw, head, or upper arms.

Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from sitting at a computer for too long. Sometimes you can strain your neck muscles from sleeping in an awkward position or overdoing it during exercise. Falls or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain.

Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. You rarely need surgery.

The optic nerve is a bundle of more than 1 million nerve fibers that carry visual messages. You have one connecting the back of each eye (your retina) to your brain. Damage to an optic nerve can cause vision loss. The type of vision loss and how severe it is depends on where the damage occurs. It may affect one or both eyes.

There are many different types of optic nerve disorders, including:

• Glaucoma is a group of diseases that are the leading cause of blindness in the United States. Glaucoma usually happens when the fluid pressure inside the eyes slowly rises and damages the optic nerve.
• Optic neuritis is an inflammation of the optic nerve. Causes include infections and immune-related illnesses such as multiple sclerosis. Sometimes the cause is unknown.
• Optic nerve atrophy is damage to the optic nerve. Causes include poor blood flow to the eye, disease, trauma, or exposure to toxic substances.
• Optic nerve head drusen are pockets of protein and calcium salts that build up in the optic nerve over time

Contact your health care provider if you are having vision problems. Tests for optic nerve disorders may include eye exams, ophthalmoscopy (an examination of the back of your eye), and imaging tests. Treatment depends on which disorder that you have. With some optic nerve disorders, you may get your vision back. With others, there is no treatment, or treatment may only prevent further vision loss.

If you have a swallowing disorder, you may have difficulty or pain when swallowing. Some people cannot swallow at all. Others may have trouble swallowing liquids, foods, or saliva. This makes it hard to eat. Often, it can be difficult to take in enough calories and fluids to nourish your body.

Anyone can have a swallowing disorder, but it is more common in older adults. It often happens because of other conditions, including:

• Nervous system disorders, such as Parkinson's disease and cerebral palsy
• Problems with your esophagus, including GERD (gastroesophageal reflux disease)
• Stroke
• Head or spinal cord injury
• Cancer of the head, neck, or esophagus

Medicines can help some people, while others may need surgery. Swallowing treatment with a speech-language pathologist can help. You may find it helpful to change your diet or hold your head or neck in a certain way when you eat. In very serious cases, people may need feeding tubes.

NIH: National Institute on Deafness and Other Communication Disorders