Botulinum toxin injections are the treatments of choice for most forms of focal dystonia. The toxin is produced by the bacterium that causes botulism. When a small amount of commercially prepared toxin is selectively injected in the overactive muscles, it causes a change in the muscle firing, calming the abnormal movements for up to several months at a time.
Patients with widespread or severe debilitating dystonia can also benefit from surgery (thalamotomy or deep brain stimulation) if they are unresponsive to other treatments. The most widely used current surgical approach is called deep brain stimulation, or DBS. In this surgery, thin electrodes are implanted into a part of the basal ganglia called the globus pallidus and are attached to a pacemaker-like device implanted in the chest wall. These electrodes deliver controlled electrical pulses that can have a marked improvement of dystonia symptoms, especially for patients with generalized primary dystonia.