Dystonia

Dystonia involved involuntary muscle contractions resulting in muscle spasms, repetitive movements and abnormal postures.

Dystonias can affect different parts of the body, including single muscles, muscle groups or muscles throughout the body. Some dystonias are focal, meaning only activated when specific motor patterns are initiated.   Others are more broad and are activated with any use of a muscle set.   They are categorized in the following way:

• Generalized Dystonia - affects most or all of the body
• Focal Dystonia - is localized to a specific part of the body
• Multifocal Dystonia - involves two or more unrelated body parts
• Segmental Dystonia -  affects to or more adjacent body parts
• Hemidystonia - involves the arm and leg on the same side of the body

Speech Pathology Care for Dystonias

Some focal dystonias that may include adjuvant treatment with Speech Pathology at URMC are:

Oromandibular Dystonia

• Oromandibular dystonia involves spasming of muscles used during speech production, including the face, jaw and tongue.  Chewing and swallowing may also be affected.

​Respiratory Dystonia

• Respiratory dystonia also known as respiratory laryngeal dystonia is characterized by atypical laryngeal movements which results in airway obstruction.  The symptoms are persistent shortness of breath, without triggers and paradoxical motion of vocal folds on laryngoscopy.    This disorder can occur in isolation or in conjunction with Spasmodic Dysphonia.   

Spasmodic Dysphonia

• Spasmodic dysphonia (SD) is a focal DYSTONIA (aberrant muscle movement) that is activated only with speech.  More information can be found here (insert link)

Treatment for Dystonias

• Botox
• Medications such as anticholinergic agents, GABAergic agents or dopaminergic agents
• Deep Brain Stimulation (DBS)

Speech-Pathology Treatment for Respiratory Dystonia

Standard PVFM treatment is often unsuccessful.  Botox to affected muscles has shown efficacy.  Respiratory retraining to balance and maximize underlying respiratory function can also be helpful in managing this disorder.

Additional Resources

National Institute for Neurological Disorders and Stroke – Dystonias Fact Sheet