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I have had MS for 10+ years and now I have been diagnosed with focal distonia.

By Anonymous April 22, 2010 - 5:07pm
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It is very irritating to not be able to write with my dominate (right) hand. I have to write with my left hand and it's not so good!
Is there and cure, can it go away, or are there any good treatments?

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Expert HERWriter Guide Blogger

Anon - There's a 50/50 chance it's related to the MS. Here's information from the article referenced earlier:
Investigators believe that the dystonias result from an abnormality in an area of the brain called the basal ganglia where some of the messages that initiate muscle contractions are processed. Scientists suspect a defect in the body's ability to process a group of chemicals called neurotransmitters that help cells in the brain communicate with each other. Some of these neurotransmitters include:

* GABA (gamma-aminobutyric acid), an inhibitory substance that helps the brain maintain muscle control.
* Dopamine, an inhibitory chemical that influences the brain's control of movement.
* Acetylcholine, an excitatory chemical that helps regulate dopamine in the brain. In the body, acetylcholine released at nerve endings causes muscle contraction.
* Norepinephrine and serotonin, inhibitory chemicals that help the brain regulate acetylcholine.

Acquired dystonia, also called secondary dystonia, results from environmental or disease-related damage to the basal ganglia. Birth injury (particularly due to lack of oxygen), certain infections, reactions to certain drugs, heavy-metal or carbon monoxide poisoning, trauma, or stroke can cause dystonic symptoms. Dystonias can also be symptoms of other diseases, some of which may be hereditary.

About half the cases of dystonia have no connection to disease or injury and are called primary or idiopathic dystonia. Of the primary dystonias, many cases appear to be inherited in a dominant manner; i.e., only one carrier parent need contribute the dystonia gene for the disease to occur, each child having a 50/50 chance of being a carrier. In dystonia, however, a carrier may or may not develop a dystonia and the symptoms may vary widely even among members of the same family. The product of one defective gene appears to be sufficient to cause the chemical imbalances that may lead to dystonia; but the possibility exists that another gene or genes and environmental factors may play a role.

May 2, 2010 - 6:40am
Expert HERWriter Guide Blogger

Hi Anon - Thanks for writing and sharing your situation with us. For those who don't know the term, dystonias are movement disorders in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. The movements, which are involuntary and sometimes painful, may affect a single muscle; a group of muscles such as those in the arms, legs, or neck; or the entire body. Those with dystonia usually have normal intelligence and no associated psychiatric disorders.

Generalized dystonia affects most or all of the body, while a focal dystonia is localized to a specific part of the body. Anon, it sounds like your focal dystonia is in your right hand, is that correct?

While it might seem that the problem lies in the concentrated area of the muscle group it starts in the mapping system of the brain that controls fine motor skills and sensory information. A thin layer of tissue, called the sensorimotor cortex, lies above the brain and categorizes the movements of individual muscle function. During Focal Dystonia the categories are no longer distinct and unable to be controlled accurately.

The brain is constantly adapting and developing to the human it belongs and, for the most part, this is a very beneficial thing for our overall functionality and well being. But the brains of those who have developed focal dystonia have adapted to the unnatural movements of the muscle group and, to make it easier for the body, have created a type of shortcut.

To treat focal dystonia, many opt for botox injections, paralyzing the unnatural contractions of the affected muscle. Because the problem lies in the brain, not in the muscle itself, the condition is not fixed but rather only appeased temporarily.

As this is not a cure for Focal Dystonia further research has been conducted to reverse the brain’s adapted function to its original utility. A program developed by UCSF researcher, Dr. Nancy Byl, is called sensorimotor retraining. In short, the brain must re-learn the desired functions by exaggerating the sensory function of the brain.
reatment includes the everyday natural use of the muscles, sending reminders to the brain of how these muscle groups should move and feel.

Gradual changes to the muscle functions that have become second nature to you and your brain are imperative to the reversal of Focal Dystonia. The symptoms of this muscle condition can be frustrating and the treatments, seemingly endless but as more research is being conducted more effective steps for management of the disorder becomes available every day.

You can find more information about focal dystonia at this link from the National Institute of Neural Disorders and Stoke: http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm

Will you let us know if this information has been helpful? Thanks, Pat

April 22, 2010 - 6:47pm
EmpowHER Guest
Anonymous (reply to Pat Elliott)

Yes, this was helpful. I understand why this problem persists because it is caused by the brain and not the muscles. I am considering botox for temporary relief but hope that I can learn info to reverse the situation when I go to a "movement specialist" this month. Is this condition related to MS or is it a condition all by itself? Thank you for your detailed answer to my original question.

May 2, 2010 - 5:20am
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