Features suggestive of an acquired dystonia:

  • Sudden onset and rapid progression
  • Hemidystonia
  • Cranial onset in childhood
  • Restricted focal/segmental dystonia with childhood onset
  • Onset in legs in adults
  • Progression to generalized dystonia with adult-onset
  • Prominent oral (bulbar) involvement
  • Other neurological or systemic signs
  • Presence of painful spasms (tonic spasms)

Drug-induced dystonia

There are many medications (including over-the-counter medications) that can either trigger an acute dystonic reaction, or if taken long enough can trigger a permanent problem with dystonia.

Some offending medications include:

  • Levodopa
  • Bromocriptine
  • Antipsychotics
  • Metoclopramide (Maxeran)
  • Dilantin
  • Calcium channel blocker
  • SSRI antidepressants
  • Ergotamines
  • Antihistamines

Post-traumatic dystonia

Dystonia can occur after a variety of different types of trauma, including head injury,  peripheral injury, and electrical injury. There is typically a delay of a few years between the brain injury and the onset of dystonia


Dystonia can occur after exposure to a variety of different types of toxic substances, including; manganese, wasp stings, carbon monoxide, carbon disulfide, and methanol.


Dystonia can occur after brain damage due to lack of oxygen. This is seen in children with cerebral palsy due to being deprived of oxygen at birth. It can occur in adults after stoke (a focal loss of oxygen supply to the brain due to a blood vessel becoming blocked) or following a heart attack (complete loss of oxygen supply to the brain).


Dystonia can occur after exposure to a variety of different types of infections that affect the brain including; viral encephalitis, toxoplasmosis, syphilis, AIDS, Jakob Creutzfeldt disease.

Hypnogenic dystonia

Dystonia occasionally only occurs during the night while sleeping. One form of hypnogenic dystonia is likely due to a  seizure disorder.


There are some other conditions that can result in abnormal or twisted postures that are not due to dystonia. One example would be a dislocation of the bones of the upper neck  (atlanto-axial subluxation) resulting in a twisted neck mimicking cervical dystonia.

Functional disorders

Dystonia can occur as a result of a disturbance of brain functioning unassociated with any actual damage to the brain.

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