Padraig O'Suilleabhain, M.D. Answers Questions On: Dystonia

Dystonia is a movement disorder in which muscles contract excessively and without the normal specificity. There is overflow of activation to adjacent neurons and  muscles. In many cases, we’re not sure what causes the contraction, but that doesn’t mean we can’t treat it. We can usually help quite substantially to reduce the symptoms of dystonia with the current treatments – injections, surgeries, or medications.

In addition to the treatments proven helpful overall,  there is  an art to the treatment of dystonia and other movement disorders. Each patient is unique and treatment needs to be individualized.

We just completed a small study of 50 patients who came for botulinum toxin (such as Botox) injections for dystonia. Patients typically come in three-month cycles to get relief with the injections because the benefits historically wear off by that time. It had been suggested in a pilot study that oral zinc supplementation would extend the benefits of the botulinum toxin injections, and I wanted to see if it was true and how much it would help. There is a plausible scientific basis for this because these toxins are stabilized in nature by binding to zinc. We had 50 patients take a zinc supplement for a week before one of their injection cycles and take a placebo before another injection cycle. Patients graded the outcome to see whether zinc had any benefit on how well they responded, how long, and how much relief. It ended up showing that the supplement made a small difference that was not statistically significant.

It would be marvelous if something as simple as an inexpensive safe supplement had even a marginal effect on response to this expensive therapy, or gave a little extra edge to the treatment. This was the hypothesis and though it doesn’t look promising enough in terms of the degree of benefit, we’ll keep looking for better ways to help our patients.