General Medical Information

Dystonia

Frank E. Lucente
Samir Shah
Roger Kula

Dystonia of the tongue or lips and facial grimacing may be caused by extrapyramidal disease or drug intoxication. Torsion spasm involves excess muscle tone in large muscle groups. This may involve the entire body. Movements are slow, undulant, writhing, and twisting. This disorder may involve only the face, tongue, head, and neck, leading to dysarthria, facial grimacing, and torticollis. Meige syndrome, known as cranial dystonia, presents with focal or segmental dystonia involving the cranial muscles. The most common example is blepharospasm. Dystonia musculorum deformans is a rare, progressive, familial disorder manifesting dystonia. Tardive dyskinesia is a dystonia of the lips, tongue, and facial muscles. This is a late side effect of phenothiazines that can occur even after discontinuation of the drug. Spasmodic torticollis involves dystonic movement of the head, neck, and shoulders. Initially, this is intermittent, but it can later develop into persistent muscle contraction with deviation of the head. This condition can be congenital or acquired. Some cases may be psychogenic. Spastic dysphonia is considered to be a focal dystonia of the larynx.