The first step in treating dystonia is to determine as much as possible about the underlying cause, which may influence the course of treatment your neurologist recommends.
Our Movement Disorders team at UT Southwestern includes physicians who all have advanced training in movement disorders and in the management of dystonia.
Some of the treatment options provided by UT Southwestern include:
- Medication: The following drugs may provide relief from dystonia symptoms:
- Anticholinergics, such as trihexyphenidyl or benztropine, block a neurotransmitter called acetylcholine, which contributes to muscle spasms in some dystonia cases.
- Benzodiazepines, such as diazepam and clonazepam, act like muscle relaxants through the GABA system, a system that inhibits the transmission of nerve signals in the brain and spinal cord.
- Baclofen is a muscle relaxer and is commonly used to treat select cases of dystonia, for example, dystonia following traumatic injury to the central nervous system.
- Carbidopa and levodopa can increase levels of the neurotransmitter dopamine. A reduced level of dopamine is one of the possible causes of dystonia. Levodopa is converted to dopamine in the brain; carbidopa keeps levodopa from being broken down before it reaches the brain.
- Botulinum toxin injection: UT Southwestern specializes in the use of botulinum toxin injections for a variety of dystonias, including focal dystonia and cervical dystonia, which result in involuntary muscle contractions.
Botulinum toxin is injected into the affected muscles, where it helps to relax the muscles, reducing excessive muscle contraction and the associated pain. The effect comes on gradually over seven to 10 days. Results last for about three months, so injections are repeated at regular intervals to maintain ongoing benefits.
- Surgery: Selective denervation surgery is a surgical procedure that involves cutting the nerves controlling the overactive muscles that are causing the dystonia. If this treatment is recommended, patients will be sent to an out-of-state facility for surgery. Postoperative care will be provided by a UT Southwestern physician.
Another option is a pump that delivers small doses of baclofen directly to the spinal fluid. The pump is placed under the skin of the abdomen, along with a small catheter that is inserted into the fluid around the spinal cord, tunneled under the skin, and connected to the pump. The pump is programmed by a remote computerized device to deliver the amount of baclofen your physician recommends. The medication relaxes muscles throughout the body and appears especially effective at targeting dystonia affecting the legs.
- Deep brain stimulation (DBS): UT Southwestern offers this neurosurgical procedure, which for some patients is the best solution for dystonia.
DBS involves a neurosurgeon implanting electrodes into a specific part of your brain. The electrodes are connected to a generator implanted in your chest near your collarbone that sends electrical pulses to your brain. DBS may help reduce dystonia symptoms.
Most patients notice a 25 to 80 percent improvement in symptoms with DBS. Your outcome will depend on the type of dystonia you have, your age, and how long you’ve suffered from dystonia when you have the surgery.
- Occupational, speech, and physical therapy: Many forms of dystonia affect mobility, posture, balance, stamina, and the ability to complete everyday tasks. Physical therapy may help improve flexibility and strengthen weakened muscles.
Spasmodic dystonia or voice dystonia can cause involuntary spasms in the throat muscles that are responsible for speech, resulting in a change in vocal quality. People with these types of dystonia may benefit from speech therapy.
Request an Appointment
To schedule an appointment with a dystonia specialist at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.