Parkinson’s disease and Dystonia

Dystonia and Parkinson’s Disease

Have you ever experienced a painful cramped foot or curled, clenched toes as part of life with Parkinson’s? These symptoms can often be a tell-tale sign of dystonia — sustained and often painful muscle twisting, spasms and cramps. Dystonia can be an early symptom of PD, or it can develop later, as a side effect of levodopa.

People with Parkinson’s commonly experience dystonia as a cramp in the foot that causes the toes to curl and stay clenched. In fact, in some people, a foot dystonia induced by walking or running may be one of the very first signs of the illness.

More commonly people who are being treated for PD complain of painful dystonia of the foot on the more severely affected side. This painful cramp usually goes away after the first dose of PD medications. Less commonly in treated patients, dystonia can affect other body parts and come and go throughout the day.

Dystonia can affect other parts of the body too. It causes forceful twisting movements that, for example, can draw a person’s arm behind their back, or pull the head to the side or toward the chest. These movements are different from the flowing, writhing movements of dyskinesia, which are not painful.

Although people with PD sometimes have dystonia, it also is its own movement disorder — people can have dystonia without having PD. Whether dystonia is part of PD or not, it is caused by changes in an area of the brain called the basal ganglia, and is often treated with the same medications.

Common Symptoms

Pain. The twisting and cramping of muscles in dystonia are among the most painful symptoms experienced by people with PD.

Parts of the body affected by dystonia:

Arms, hands, legs and feet: involuntary movements and spasms.

Neck: may twist uncomfortably, causing the head to be pulled down, or to one side. This is called cervical dystonia or spasmodic torticollis.

Eyes: muscles around the eyes may squeeze involuntarily, leading a person to blink too much or to have difficulty opening the eyes.

Vocal cords and swallowing muscles: a person’s voice may sound strangled, hoarse or breathy.

Face and jaw: the jaw may open or close forcefully or there may be grimacing of the face.

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