There is no cure for dystonia, but the right treatment can help manage your symptoms and reduce unwanted muscle movements. Specialists at Penn Medicine’s Movement Disorders Center offer all available treatment options for dystonia.
Understanding Dystonia Treatment Options
Treatment for dystonia depends on the type, the severity of symptoms, the affected body areas, and any causes identified during dystonia diagnosis.
Some causes of dystonia are easier to treat than others. For example, if you take a medication that causes acute dystonia as a side effect, stopping that medication may bring relief.
Rehabilitative therapies may help people with task-related dystonia and other symptoms affecting mobility, speech, or daily activities. If medications or therapy do not ease symptoms, advanced procedures such as surgery with neuromodulation can alter nerve activity and restore function.
Dystonia Medications
Medications are often a first step in managing dystonia symptoms. Medications for dystonia work by changing the way nerve signals control muscle movement. It may take several months to find the right medication dose.
Some medications used to treat dystonia target specific chemical messengers (neurotransmitters) in the brain that control muscle movement.
- Carbidopa-levodopa increases the level of dopamine in the brain. Some rare types of dystonia are caused by dopamine deficiency and respond well to this medication. This medication is often used to treat Parkinson’s disease, which may be an underlying cause of dystonia.
- Deutetrabenazine and tetrabenazine reduce levels of dopamine in the brain. Excess dopamine can result in excessive, involuntary movement. These drugs help reduce the excessive movement that occurs in Huntington’s disease and may help in some forms of dystonia.
- Trihexyphenidyl is an anticholinergic medication that blocks the activity of the neurotransmitter acetylcholine in the brain. Anticholinergics are the most widely used drugs to treat dystonia. These drugs may be helpful for some adults but can cause side effects. They are more effective for children with dystonia.
Other medications work by slowing down communication between nerves in the brain.
- Botulinum toxin injections are often the treatment of choice for dystonia, especially focal and segmental dystonias. These injections weaken specific muscle groups by blocking the signal between nerve and muscle. Botulinum toxin is the most effective treatment strategy for focal dystonia, reducing and sometimes eliminating localized muscle spasming, especially in the neck, face, and vocal cords. It can also be used to treat dystonia in the limbs. People receiving botulinum toxin injections for dystonia require repeat injections every three to four months.
- Baclofen is a muscle relaxant that decreases muscle spasms. This drug may be most useful in treating dystonias beginning in childhood, especially dystonias that occur along with spasticity (muscle stiffness).
- Clonazepam and diazepam can help reduce involuntary movements and uncomfortable muscle contractions from dystonia. They both can also reduce anxiety, which can exacerbate dystonia.
Rehabilitative Therapies
Dystonia may affect posture, communication, and your ability to perform daily tasks. Rehabilitative therapies may help people with dystonia improve or maintain coordination and control of movement.
- Physical therapy uses stretches, therapeutic massage, and specific exercises to decrease muscle pain and tightness. This can also improve functional mobility and posture. Physical therapists can teach people with dystonia how to use sensory tricks, such as touching specific body areas, to briefly stop the muscle from spasming.
- Occupational therapy helps people with movement disorders perform daily tasks, such as dressing, bathing, and eating. Occupational therapists may recommend assistive devices that make these tasks easier.
- Speech therapy can help improve the ability to communicate if dystonia impacts the vocal cords. Speech therapists can also provide exercises to help coordinate muscles involved in swallowing if they are affected.
Dystonia Surgery
If medications and therapies are not able to manage dystonia symptoms, your doctor may recommend a surgical procedure to relieve the muscle spasms.
Surgical options for dystonia include:
- Deep brain stimulation (DBS): An implanted medical device uses electrical stimulation to change electrical activity in the brain region causing dystonia symptoms. DBS is most effective for people with widespread symptoms affecting both sides of the body. It can also be used to treat dystonia affecting only one body segment or several segments.
- Intrathecal baclofen pumps: An implanted medical device pumps a muscle relaxant called baclofen directly to the area around the spinal cord. This procedure may be an option for people with dystonia who don’t respond well to oral medications or who experience side effects from high doses of medication. People with implanted intrathecal baclofen pumps typically need less medication, experience fewer side effects, and achieve faster reduction in symptoms than people with dystonia who take baclofen by mouth.
Why Choose Penn Medicine Movement Disorders Center for Dystonia Treatment?
At Penn Medicine, our collaborative Movement Disorders Center team has extensive experience treating even rare forms of dystonia. We prioritize your comfort and safety and work with you to find the best treatment option for your symptoms and lifestyle.
People who choose us for dystonia treatment find:
- Extensive treatment options: The right treatment for dystonia is highly personal. Our team has experience with all available medication and surgical options for dystonia management. Our expert neurosurgeons use the most advanced technology and minimally invasive techniques available. We work closely with you to understand your needs, preferences, and goals and help you select the option that’s right for you.
- Telemedicine appointments: Getting to and from a doctor’s appointment can be challenging for people with movement disorders. When appropriate, our providers offer virtual consultations, monitoring, and follow-up visits. Newer DBS systems can also be programmed remotely.
Make an Appointment
Please call 800-789-7366 or make an appointment.