Definition

Disorder of the voltage, the tone.

Classification

• The neurovegetative Dystonia or vagosympathetic is a disorder of the passage of nerve excitation at the level of the vagus nerve (also called vagus nerve). This nerve allows sensations and transmission of orders to the muscles of the movements of the pharynx, stomach, larynx, the heart, liver and intestines. This leads to the amphotonie, which is an excess of tone on the two systems: the sympathetic nerve and vagus nerve.
• The hypoamphotonie corresponds to hypotonia (decreased normal tone) of these two systems.
• The sympathicotonie corresponds to a tone increased to the level of organs innervated by the sympathetic system.
• The vagotonie corresponds to an excess of organs innervated by the vagus nerve or vagally tone.

Symptoms

• Vertiginous sense
• Uncomfortable with the changes of position due to hypotension (blood pressure drop)
• A dry syndrome (dry mouth, dry eyes)
• Hypersudation (abnormal increase in the emission of sweat) at the level of the face and trunk
• Digestive disorders: constipation, diarrhea
• Genital disorders
• Urinary disorders
• High blood pressure
• Shock
• Angina Pectoris
• Hyperthyroidism (excessive secretion of thyroid hormones)
• Hypoglycemia (fall of sugar in the blood)
• Parkinsonian syndrome

Treatment

There is no currently of effective treatment in this type of dystonia.L-dopa and dopamine agents (in relation to dopamine, neurotransmitter belonging to Catecholamines) are tested first. Most often, they are ineffective and sometimes aggravating. Given that there are dopaminosensibles dystonies, it is nevertheless necessary to try these drugs. Sometimes associated with an agent dopamine as bromocriptine introduced in a progressive manner.Fails, is used in a second time an anticholinergic (drug action opposed to that of acetylcholine, another mediator in the central nervous system) which is sometimes effective (trihexyphénidyle).In the case of inefficiency, it is possible to use benzodiazepines, sometimes at very high doses such as diazepam and baclofen.If the previous ones, it is also possible to use certain antipsychotics (Haloperidol, pimozide), or dépléteurs (which decreases action) dopamine (tetrabenazine).In the presence of muscle dystonies particularly severe and resistant to medicines previously cited, some physicians are using baclofen injection, which sometimes gives good results in a few cases of dystonies very disabling.The intervention on the Central grey nuclei (pallidum) gave some transient, more marked improvements on dystonia of the members than on that of the trunk.The use of botulinum toxin is almost not with respect to this variety of dystonia. Nonetheless, the indication may sometimes discuss in cases where there is a very disabling localized Dystonia (foot, neck, hand).In the dopaminosensibles dystonies, the use of L-dopa and carbidopa is at the origin of a very interesting improvements and sometimes even a disappearance of symptoms with often low doses. The treatment is maintained indefinitely.In syndrome of Parkinson-juvenile Dystonia, L-dopa treatment results are more often limited.