The dystonias are movement disorders with 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.The commonly encountered dystonias are those involving eye lids,neck musles,writers cramp and druginduced dystonias.

CLASSIFICATION:

Depending upon distribution

Generalized dystonia affects most or all of the body.
Focal dystonia is localized to a specific part of the body.
Multifocal dystonia involves two or more unrelated body parts.
Segmental dystonia affects two or more adjacent parts of the body.
Hemidystonia involves the arm and leg on the same side of the body

Another Classification is into
Primary dystonia
Secondary Dystonia

Primary dystonia is subdivided into familial and non familial.

Focal dystonia indctes that only single area of the body is affected.examples include torticolis,blepharospasm, and writers cramp.As ageneral rule primary dystonia begins as focal.The disorder may either remain focal or spread to other parts of the body.
When it spread it mostly does so mostly affecting the contiguos body part.When dystonia affect two or mopre body part it is called segmental dystonia.
The generalised dystonia refers to the dystonia affecting at least one or both legs and some other regiion of the body.If only one leg is affected trunk must also be involved to qualify generalised dystonia.
The term multifocal dystonia fiis a gap in the above designation.it applies to involvement of two or more noncontagius part of the body
Hemidystonia refers to dystonia affecting one half of body.

Secondary Dystonias:
The folloing disorders may cause secondary Dystonia


Wilsons Disease
GM-1 Gangliosidosis
GM-2 Gangliosidosis
Metachromatic Leucodystrophy
Homocystinuria
Mitochondrial disorders
Fahrs Syndrome
Hallervorden Spatz disease
Dystonic Lipidosis
Ataxia Telengiectasia
Neuro acanthocytosis
Huntingtons Disease
Pelizaeus Merzabacher Disease
Machado Josephs Disease
OPCA
Stroke
AVM
Trauma
Encephalitis
Trauma
Drugs
Toxins

INVESTIGATIONS:
CT head
MRI Brain
ESR
Serum Ceruloplasmin

TREATMENT
Anticholinergic Drugs
Anti Muscarinic Agents
Dopamine agonists and Antagonists
Botulinum Toxin