Travel with Confidence: Top Hospitals for Expert Dystonia Care

Dystonia

Dystonia is a motor disorder of the nervous system whereby the muscles contract automatically resulting in repetitive or twisting movements, abnormal postures or trembles. It may involve a single part of the body (focal), or multiple adjacent parts (segmental) or the whole body (generalized).

Key Features

• Spasmodic contractions of muscles.
• Tremors, twisting movements.
• Abnormal or fixed postures
• May increase with stress, fatigue, or particular activities.

Types of Dystonia

• Focal dystonia - is only one localized (e.g. writer cramp or cervical dystonia of the neck).
• Segmental dystonia- two or more adjacent regions (e.g. face and neck).
• Multifocal dystonia - involves two or more unrelated regions.
• Generalized dystonia - affects more than two parts of the body including the trunk.
• Hemidystonia - one part of the body is affected (in many cases associated with brain damage).

Dystonia symptoms

Below is a clear list of typical symptoms of dystonia (they change by type and the part of the body involved):

Main Symptoms

• Muscle spasms or involuntary muscle contractions- without control muscles become tight and/or spasm.
• Abnormal postures- body parts bend or remain in an abnormal position.
• Repeated movements - turning of the neck, blinking or cramping.
• Shaky movements - common in the neck, hands or head.
• Task-specific issues- these problems are present in some activities (e.g., writing, playing an instrument).
• Suffering or discomfort - due to long-term abnormal posture or muscle strain.

Symptoms by Area

• Neck (cervical dystonia): Head is tilted, turned or pulled to the side; neck pain.
• Eyelids (blepharospasm): Blinking that is uncontrollable, trouble staying open.
• Jaw/face (oromandibular dystonia): Problems talking, chewing or swallowing.
• Vocal cords (spasmodic dysphonia): Tense or tremulous voice.
• Hand/arm (writer cramp, musician dystonia): Loss of control when writing or playing, hand cramps.
• Legs/trunk: Torso twists, walks with an abnormal gait, foot turns inwards during walking.

Dystonia causes

There are a variety of causes of dystonia, whether primary (idiopathic/genetic) or secondary (a consequence of another condition or trigger). A breakdown in detail is as follows:

Primary (Idiopathic/Genetic) Causes

• Genetic mutations (inherited or spontaneous) - some gene changes (such as DYT1, DYT6) are associated with dystonia.
• In many cases, there is no detectable brain damage - the unusual brain signaling occurs without an obvious outside cause.
• There may be family history of movement disorders or dystonia.

Secondary Causes (Acquired)

This form as secondary to another disease, damage, or exposure:

Brain-related causes

• Stroke
• Traumatic brain injury
• Brain tumors
• Infections (encephalitis, meningitis)
• Lack of oxygen (perinatal brain injury, carbon monoxide poisoning)

Neurodegenerative disorders and neurological disorders

• Parkinson’s disease
• Huntington’s disease
• Wilson disease (metabolic disorder of copper).
• Multiple sclerosis

Drug-induced (Tardive dystonia)

• Antipsychotics or anti-nausea (dopamine-blocking medications) that have been taken over a long period of time.

Systemic or metabolic disease

• Poor oxygen or glucose on delivery.
• Thyroid disorders
• Mitochondrial disorders

Dystonia diagnosis

Dystonia diagnosis is primarily clinical, although the combination of history, physical examination, and tests are used to eliminate other diagnoses. Here’s a structured overview:

Medical History

• Onset of symptoms (childhood-usually genetic, adult-usually focal).
• Familial dystonia or movement disorder.
• History of other diseases (stroke, infections, and head injury).
• Use of medications (particularly dolaminergic drugs).
• Stress (symptom triggers), activity-specific.

Neurological Examination & Physical Examination

• Involuntary muscle contractions, abnormal postures or tremors.
• Pattern (focal, segmental, generalized) identification.
• Job testing (e.g. writer test of writer cramp).
• Determining when the symptoms are reduced by sensory tricks (such as touching the chin in cervical dystonia).

Investigations

Diagnosed in order to rule out other disorders:

Imaging

• MRI/CT scan -> to identify stroke, tumor, or structural brain abnormalities.

Blood & urine tests

• To eliminate metabolic or systemic causes (e.g., Wilson’s disease, thyroid problems).

Genetic testing

• In case of hereditary dystonia (DYT1, DYT6 mutations).

Electromyography (EMG)

• Measures muscle electrical activity in order to investigate abnormal contractions.

Differentiation Diagnosis (to exclude)

• Parkinson’s disease
• Essential tremor
• Tics or Tourette’s syndrome
• Functional (psychogenic) movement disorders

Dystonia treatment

Below is a succinct overview of dystonia treatment options - there is no long term cure in most instances, however, the treatment aims at reducing muscle contractions, pain, and quality of life.

Medications

These are intended to stabilize brain chemicals and to loosen muscles:

• Anticholinergics (e.g., trihexyphenidyl) → slow excess muscle activity.
• Muscle relaxants (e.g., baclofen) → reduce spasms.
• Benzodiazepines (e.g., clonazepam, diazepam) -> relax overactive messages.
• Dopaminergic medications (e.g., levodopa) → effective in some genetic diseases such as dopa-responsive dystonia.

Botox Injections

• Applicable in most instances of focal dystonia (neck, eyelids, hands, vocal cords).
• Blocking nerve signals to targeted muscle - works to reduce spasms 3-4 months.
• Needs repeated sessions.

Deep Brain Stimulation (DBS)-Surgery

• Indicated as a treatment of severe, generalized or medication-resistant dystonia.
• Electrodes are inserted in certain parts of the brain (globus pallidus internus).
• Gives long-term muscle control and quality of life.

Physical/Supportive Therapies

• Physiotherapy - stretching, posture correction, strengthening exercises.
• Occupational therapy → writing, eating, or other daily activity adaptive devices.
• Speech therapy → when speech/swallowing muscles are involved.
• Stress management/ relaxation methods - they are better because stress tends to aggravate the symptoms.

Treating Secondary Causes

• When dystonia is caused by another illness (e.g. Wilson disease, stroke, dystonia caused by drugs) → it is necessary to treat the underlying cause.

Best neurologists for dystonia

• Dr. Sumit Singh
• Dr. Arun Garg
• Dr. Praveen Gupta
• Dr. Mukesh Kumar

Top Hospitals for Expert Dystonia Care

Artemis Hospital, Gurgaon

• It has its own Department of Neurosciences, providing the latest neurological treatment, under the guidance of highly experienced professionals. 

Dystonia Care Movement Disorder Care:

• Botulinum Toxin Therapy: Botox dystonia and spasticity therapy falls under the neurosciences rubric. 
• Deep Brain Stimulation (DBS):Artemis would provide DBS surgery to restore movement (such as dystonia), using the latest advancements in neurosurgical practice. 
• Movement Disorder-Specific Clinics: As an extension of its “Integrated Practicing Unit(s), the hospital has a Parkinson’s Disease Clinic (Movement Disorder Clinic), which deals with dystonia among others.

Medanta-The Medicity, Gurgaon

Founded in 2009 by Dr. Naresh Trehan and Sunil Sachdeva, Medanta is one of the most successful multi-super-specialty hospital networks with headquarters in Gurgaon, Haryana. Neurological disorders such as Parkinson, tremors, and dystonia are provided at the millennium neurosciences institute of Gurugram, Medanta. Provides the latest diagnostics and individual treatment plans through the multidisciplinary approach involving neurosurgeons and neurologists.

Fortis Memorial Research Institute, Gurgaon

FMRI is definitely a Center of Excellence when it comes to Neurosciences. It accommodates subspecialty programs, such as Epilepsy Surgery, Interventional Neurology and Deep Brain Stimulation (DBS). FMRI has successfully completed Deep Brain Stimulation (DBS) surgeries on dystonia, with one of the most prominent examples of Deep Brain Stimulation being a patient who was otherwise bedridden by severe genetic dystonia, but who acquired the ability to walk again soon after he had bilateral implants of globus pallidus internus (GPI) DBS. State-of-the-art infrastructure, including neuronavigation, CT-based BrainSUITE and the latest versions of MRI/CT resources, gives the hospital Department of Neurosurgery and Neurology additional strength in diagnosing and treatment of movement disorders such as dystonia.

Max Hospital, Saket

Has a full Neurosciences department with a Movement Disorder Clinic- central to management of dystonia. Some of the latest technologies found in infrastructure are the first BrainSuite intraoperative MRI, 1.5T MRI, CT-Angio and neuronavigation in Asia. Deep Brain Stimulation (DBS): Max Saket is credited with DBS as a therapy against movement disorders such as dystonia, Parkinson, and essential tremor. Movement Disorder Care: The hospital has a Movement Disorder Clinic that provides services that include Botulinum toxin (Botox) and other neurology-related interventions to address the symptoms of dystonia.

Dystonia treatment in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Dystonia treatment.
• Expert neurologist with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food