Treatment options for dystonia 

Botulinum toxin

Widely used to treat neurological conditions that involve abnormal muscle contractions, such as dystonia.

It works by stopping the neurotransmitters responsible for muscle spasms reaching the affected muscles.

  • Effective for most types of dystonia.
  • Easily administered by injection directly into the affected muscles.
  • Follow-up injections are usually needed every three months.
  • The site of the injection can be painful.
  • Depending on where the injections are given, side effects can include drooping eyes, double vision, difficulty swallowing (dysphagia), or hoarseness.



Medication that blocks the effects of a chemical called acetylcholine, which can be responsible for muscle spasms.

  • Can be used to treat all types of dystonia (however, it’s mainly used to treat generalised dystonia, because botulinum toxin tends to be used to treat focal and segmental dystonia).
  • Only effective in a minority of cases.
  • Side effects can include dry mouth, constipation, difficulty urinating, blurred vision, memory problems and confusion.

Medication that's sometimes used to treat spasticity (excessive muscular tension) caused by stroke or multiple scelrosis; it’s also been found to be beneficial in treating dystonia.

  • Daily doses of Baclofen have been shown to be effective in treating people with segmental, generalised and oromandibular dystonia.
  • Can cause a range of side effects. Common side effects include kidney problems, nausea, drowsiness, confusion and balance and co-ordination problems. 
Muscle relaxants

Increase the levels of a neurotransmitter called gamma-aminobutyric acid (GABA), which helps to relax affected muscles. Sometimes used to treat dystonia that fails to respond to other types of medication.

  • Can be an effective treatment when other types of medication have failed.
  • Can cause withdrawal symptoms if dose is suddenly stopped.
  • Side effects include drowsiness, tiredness, muscle weakness, dizziness and impaired co-ordination (these side effects are temporary and should disappear when your body gets used to the medication).



Specific exercises are used to help manage muscle spasms and contractions.


Helps to:

  • maintain a full range of motion
  • improve your posture
  • prevent the shortening or weakening of affected muscles


  • Long-term commitment needed to achieve results.
  • Lack of good quality evidence to show that physiotherapy is an effective treatment for dystonia.


Deep brain stimulation (DBS)

During surgery, two small electrodes are positioned on a part of the brain that affects muscle movement.

The electrodes are connected to a small pulse generator that sends signals to the brain, which alter nerve impulses and improve the symptoms of dystonia.

  • Can be effective in treating generalised dystonia that fails to respond to other treatments.
  • The surgery is reversible and causes no permanent changes to the structure of the brain.
  • There’s a risk that the pulse generator will stop working or the electrodes will become displaced, which may mean that further surgery is required.
  • As DBS is still a relatively new treatment, there’s little information about its safety or long-term effectiveness.
  • Access to DBS may be limited and it may only be available as part of a clinical trial.
Selective peripheral denervation

Type of surgery where some of the nerve endings connected to the neck muscles are cut away.

  • Can be used to treat cervical dystonia that doesn’t respond to other treatment methods (however, it’s now only used in a few, very select cases).
  • After surgery, it’s likely that you’ll experience some loss of feeling in your neck.
  • Although complications are uncommon, they can include post-operative infection, temporary swelling in the neck, pins and needles in the neck and occasional neck pain.