Dystonia is one of the symptoms of Parkinson’s disease that usually begins in one body region, such as the neck, face, vocal cords, arm, or leg, and then may spread to other parts of the body. Contributing to deteriorating movement and posture in Parkinson’s, Dystonia is commonly characterized by involuntary occasional/repetitive twisting and muscle contractions (sustained). This subsequently results in severe pain due to muscle cramp and involuntary muscle movement.

Dystonia is more common in people who have been diagnosed with Parkinson’s at a younger age (under 40) and affects nearly 40% people living with the disease. Just like any other Parkinson’s symptoms, it can be mild or severe, depending on the severity of the neurodegenerative disorder.

What causes Dystonia in Parkinson’s disease?

Dystonia likely results from dysfunction of a related brain region affected in Parkinsonism. While the exact cause has not been clarified yet, the shortage of dopamine in Parkinson’s disease is thought to play a role in Dystonia.

In some cases, Dystonia may arise as a result of levodopa consumption in Parkinson’s fighters.  Off-period Dystonia (characterized by postural changes in the hands, feet and neck) occurs when the effect of Levodopa is wearing off while on-period Dystonia (which can overstimulate the muscles) takes place when Levodopa is at its most effective.

Options to treat Dystonia in Parkinson’s disease

While there is no one treatment for pain caused by muscle cramps, stretching and massaging the affected area, being more active, taking over-the-counter painkillers (such as Paracetamol) can be helpful. Physical therapy may be helpful as an alternative treatment option.

Yawning may ease Dystonia in the vocal cords. Similarly, lying down, talking, singing, laughing, chewing or putting pressure on the eyebrows may help to relieve Dystonia in your eyelids.

1. Medication

If Dystonia is connected to levodopa medication, medication can be reviewed by the patient’s general practitioner. Changing timing(s) and dosages may help, considering the causes and pattern of the symptoms. Since Dystonia and Parkinson’s share common forms of treatment, Anticholinergic (such as Diazepam and Clonazepam) may improve the symptom.

2. Surgical Method

Botulinum Toxin (Botox) can be used to treat Dystonia, being injected in small doses into the affected muscle. However, the treatment needs to be repeated every two to three months. Also, the surgical procedures, particularly Deep Brain Stimulation (DBS) that are already used for Parkinson’s have been shown to help Dystonia in Parkinson’s.