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Dystonia is neurological movement disorder characterized by involuntary, sustained and painful contractions of muscles that resulting in twisting movements and abnormal body posture. Basal ganglia are the responsible part for initiating contractions. It produces different neurotransmitters and chemical substances include Acetylcholine, Dopamine, Histamine and nor adrenaline. Dystonia
is a disorder of basal ganglia.
Risk factor
Age.
It can affect all age groups. In children, it begins in hand or foot, and progress quickly. It mostly starts in individual between 40 and 60 years. Late onset appears on upper part either in neck, arm or hand, and progress slowly. truncal dystonia is usually familial.
Sex.
The female sex is more affected than male.
Heredity.
Birth injury.
Heavy metal toxicity-Lead, Manganese and Mercury.
Carbon monoxide poisoning.
Cyanide poisoning.
Space occupying lesion.
Trauma.
Viral encephalitis.
Stroke.
Portal cirrhosis of liver.
Huntington’s disease.
Error of fat metabolism.
Error of copper metabolism.
Food grain contaminated with ergot.
Precipitating factor
Stress, anxiety, depression.
Hypoxia.
Cerebral hypoglycemia.
Drugs:
Metoclopramide, Prochlorperazine, Chlorpromazine, Lithium, Oral contraceptives, Antihistamines and Phenytoin etc.
Alkalosis.
Food allergy-Coffee and meat.
Reflex irritation from intestine, uterus or skin.
Anemia or hyperemia within the brain.
Signs & symptoms
Sustained spasms and pain can affect all the activities of daily living which include walking, eating, speaking and hygiene. Pattern of signs and symptoms depend on the type of dystonia. Based upon the body part affected they are defined into various types. These include
Hemifacial dystonia.
Oro mandibular dystonia.
Blepharospasm.
Cervical dystonia.
Writer's cramp.
Hemidystonia.
Generalized dystonia.
Dystonia may be either focal which affect on specific part or multi focal which affect more than one unrelated part.
Adult type is usually focal type.
Generalized dystonia (Torsion dystonia) affects entire body, and usually start in childhood.
Cervical dystonia or spasmodic torticollis in which head is pulled and held turned left or right by contraction of one sternocleidomastoid muscle. Head is twisted upwards or backwards. Face on side of affected sterno-cleidomastoid may become smaller in children.
Painful spasms and the sustained posture of body region are relieved by slight touch.
Spasms are worse during voluntary movements (action type).
Spasms are increased during rest (rest dystonia) in some individual. This type occurs in adult type and progress to severe form.
Blepharospasm, hemifacial spasm, laryngeal spasm, tremor in speaking, strained speech, spasmodic dysphonia, writer’s cramps etc may be aggravated on stress, alcohol, chewing betel nuts, black pepper, tobacco, chocolate, coffee and sudden movements.
A severe dystonia with head pulled back, eyes drawn upward and mouth
open may occur following anti-psychotic or anti-nauseate drugs.
Treatment
Prefer an adaptive lifestyle.
Avoid overwork, fatigue and stress.
Enjoy relaxation and 8-hour sleep daily.
Ensure sufficient rest in comfortable position.
Lie down in supine position with head low and in between pillows during acute pain.
Avoid mechanical restriction of movements.
Practice comfortable and moderate physical exercise.
Practice breathing exercises to eliminate carbon dioxide.
Take sufficient magnesium, sodium, potassium, and vitamin E contain items in daily diet.
(Low Co2, low sodium chloride, low calcium, low albumin, high sodium bicarbonate, high potassium, and high magnesium can promote tetany)
Correct dehydration early.
Avoid common salt deficiency in summer.
Alcohol is allowed in small quantity.
Avoid betel nuts, tobacco and pepper (piperidine derivatives).
Avoid coffee in excess daily.
Avoid animal food products.
Avoid excess of copper containing food items-liver, squid, beef, oysters, cocoa, sesame seeds, nuts, sunflower oil, pumpkin seeds etc.
Avoid unnecessary surgical manipulation in neck.
Avoid injection preparations contain Mercury in childhood.
Eliminate all precipitating factors.
Avoid unnecessary frequent or rapid calcium injections
*
Medicinal treatment
Use medicines that can inhibit motor impulses to muscles.
Prefer pungent, sour and salts medicines for temporary relief.
Antispasmodic medicines A
Belladonna 3X, Cocculus 3X, Hyoscyamus 3X, Physostigma 3X, Stramonium 3X, Tabacum 3X.
Antispasmodic
medicines B
Chamomile 3X, Cypripedium
pubescens 3X, Caulophylum 3X, Cimicifuga 3X, Lobelia 3X,
Passiflora 3X, Scutellaria lateriflora 3X, Vibrunum opulus 3X,
and Viscum album 3X.
Other medicines C
Curare, Sodium, Potassium, Antimonium, Plumbum, and Causticum.
Ephedra 3X, Lobelia 3X, Rauwolfia 4X and Secale cor 4X are preferable in complaints starting from lower limbs.
Take medicines in ascending dose.
Magnesium contains
medicines
Alfalfa 3X, Aloe.s 3X, Colocynth 3X, Gelsemium 3X, Symphytum 3X, Taraxacum 3X, and Terminlia arjuna 3X.
Cyanide contains
medicines
Glycerrhzia glabra 3X, Laurocerasus 3X, Trifolium pratense 3X.
Salicylic acid contains
medicines
Chamomila 3X,
China 3X, Oleander 3X, and Trifolium pratense 3X.
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Remedies for dystonia
Take bitter, astringent and sweet remedies for sustained relief.
Dystonia remedies
Nux vomica 4X, China 4X, Condurango 4X, Ignatia amara 4X, Rauwolfia 4X, Symphytum 4X, and Viscum album 4X.
Piperidine contains remedies
Conium mac 4X, Lobelia 4X, Piper nigrim 4X and Trigonella 4X.
Lead contains remedies
Fucus vesiculosus 3X, Hypericum perforatum 3X, Rhus glabra 3X.
Mercury contains remedies
Arctium lappa 3X, Cinnamon 3X, Fucus vesiculosus 3X.
Copper contains remedies
Arctium lappa 3X, Nux vomica 4X.
Touch treatment
Simple touch with opposite hand or by someone on the affected hand, chin, neck or side of face may give transient relief.
Apply gentle pressure on eyebrow in blepharospasm.
Press the trunk on wall while standing in case of truncal dystonia.
Apply Magnet north pole or drink water magnetized with north pole.
Other measures
Remove Mercury amalgam dental filling
Light and large pen holders are beneficial in writer’s cramp.
Homeopathic Simple
remedies
Nux vomica 3X, Secale cor 4X and Rauwolfia 3X.
Take remedies in descending dose.
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