RE Dystonia vs. Rigidity

[Phil Gesotti <ermin@xxxxxxxxx>]

you wrote:
> Phil,
> I don't understand how rigidity could be mistaken for dystonia.  True
> dystonia as I know it could be diagnosed by practically anybody.
There's no
> mistaking the distorted limbs (most often a foot), pain, and cramping
> characteristic of dystonia.  Rigidity from what I understand is just
that,
> rigidity or paralysis, hence the name paralysis agitans (sp?)  I
suffer from
> both and I'd gladly take being rigid over a 20 minute bout with foot
> dystonia.
>
> Greg
> 47/35/35

Greg,

Good question. Per Duvoisin's book, Rigidity "..is characterizied by a
constant, even  resistance to passive manuipulation of the limbs. It is
due to a failure of reciprocal relaxation of the antagonistic muscle.
"In other words, an examiner needs to maniuplate the limb to diagnose
the rigidity. However Duvoisin also states "The patient may be aware of
the muscular rigidity .. as ... a pain, or a cramp."

Dystonia "A type of involuntary movement which is slow, twisting and
associated with forceful muscle contractions or spasms."

All this gets confusing. How painful does a cramp have to get before it
is characterized as dystonia versus regidity?  Early in my diagnosis, I
personally erroneously thought that the dystonia was rigidity. I was
later properly diagnosed and given a dopamine agonist for the dystonia.

In the final analysis, I personally feel it is the same basic mechanism
at work. Muscles are turned on when they are not supposed to be. They
fight each other. Eventually one wins, short term of long term, and
severely cramps or contorts limbs.

The main message I was trying to get across to Carol was to make sure
that she has been diagnosed properly so that she gets the proper
medication. This seems to be a tricky area even for the neuro's in us
boderline cases.

Phil Gesotti 50/46+/