Most people with the commonest forms of dystonia such as neck (cervical) dystonia and eye dystonia (blepharospasm) have primary dystonia which means there is no degeneration or structural damage to the brain. In secondary dystonias, the dystonia is caused by damage or degeneration of the brain (for example after brain injury or stroke) or exposure to particular drugs.
Secondary dystonia can sometimes appear after trauma to the brain via physical injury, or stroke. Where the injury is to the head, the symptoms often affect the side of the body which is opposite to the side of the brain injured. The injury can often result in observable damage (lesions) in the brain that can be seen using neuroimaging techniques such as MRI scans. This contrasts with primary dystonia where no abnormalities of the brain can be seen.
Secondary dystonia can also result from an injury to a part of the body other than the brain: for instance neck dystonia sometimes follows whiplash, eye dystonia (blepharospasm) can follow eye surgery and mouth dystonia (oromandibular) can follow dentistry work. Post-traumatic dystonia can sometimes be distinguished from primary dystonia because the symptoms may not respond to sensory tricks and may persist during sleep. Symptoms may also be paroxysmal which means they occur in episodes rather than being constant.
Dystonia following brain injury/damage may not appear for several months or (more rarely) several years after the injury. Treatment for posttraumatic dystonia can include medications and botulinum toxin injections.
Last reviewed March 2012
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