Neurological Sciences

, Volume 39, Issue 8, pp 1501–1502 | Cite as

Task-specific hand tremor during embouchure in a flutist

  • Jee-Eun Lee
  • Joong-Seok Kim
Letter to the Editor

Embouchure dystonia is a term used to describe a type of dystonia that affects brass and woodwind players. This dystonia exclusively affects the muscles of the lower face, tongue, jaw, and pharynx that are used to control the flow of air into the mouthpiece of a brass or woodwind instrument. The symptoms of this dystonia are often very subtle and may include air leaks at the corners of the mouth that are accompanied by a noticeable tremor, involuntary puckering, excessive elevation of the corners of the mouth, and involuntary closing of the mouth [1].

Here, we present the case of a 56-year-old amateur flute player who complained of a hand tremor which occurred exclusively while playing flute that had persisted for more than 6 months. He had been practicing the flute for more than 20 years. Several months before the onset of symptoms, his playing time had increased, and soon thereafter, he experienced postural tremor while playing the instrument. The patient did not report any sensory...


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Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10072_2018_3317_MOESM1_ESM.wmv (31.5 mb)
Video S1 Examination of the patient while he was playing flute showed coarse action tremors with a frequency of 4–5 Hz measured clinically. The tremor occurred when the patient’s mouth contacted the flute; however, it did not develop when the patient took the playing position. The patient also had a subtle postural tremor in the digits of the hands with the arms outstretched. (WMV 32279 kb)


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    Frucht SJ (2009) Embouchure dystonia—portrait of a task-specific cranial dystonia. Mov Disord 24(12):1752–1762CrossRefPubMedGoogle Scholar
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    Ondo WG, Satija P (2012) Task-specific writing tremor: clinical phenotypes, progression, treatment outcomes, and proposed nomenclature. Int J Neurosci 122(2):88–91CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurology, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea

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