Movement Disorders - Dystonia

Dystonia are stiff, involuntary postures that may occur spontaneously or with intention. They may be focal (eg, blepharospasm, torticollis, "writer's cramp"), segmental (involving one or several limbs or regions) or generalized.

 

Generalized Dystonia

Note the abnormal postures and tremors in all extremities.

 

Focal Dystonia - Writer's Cramp

Writer's cramp is an example of a focal dystonia that is use-induced. Note that at first the hand posture is normal, but as the writing continues, it becomes more and more dystonic.

 

 

Focal Dystonia - Blepharospasm

This woman has difficulty opening her eyes due to involuntary eyelid closure.

 

Focal Dystonia - Torticollis

Also known as "wry neck", the head twists to one side. Interestingly, some dystonias respond to sensory stimulation, and it is not uncommon for a patient to be able to straighten their head using "tricks" such as touching their chin.

 

Focal Dystonia - Spasmodic Dysphonia

This is a dystonia that involves laryngeal muscles. It tends to be use-induced, although in advanced cases the change in voice is constant.

 

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