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Treatment of Musicians’ Dystonia

  • Steven J. FruchtEmail author
Chapter
  • 482 Downloads
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Musicians’ dystonia is an example of a focal task-specific dystonia, i.e., dystonia affecting one part of the body, only when it is engaged in performance of a specific task. Musicians’ dystonia may involve the upper extremity (either the hand, arm, or shoulder) or the embouchure (the muscles of lower face, tongue, and pharynx that control the flow of air into a brass or woodwind instrument). Musicians’ dystonia typically affects professionals at the peak of their performing careers, often with devastating consequences. Recent work has revealed that both genetic and environmental influences contribute to the development of the condition. Current treatments for musicians’ dystonia include instrument modification, physical therapy, oral medication, injection of botulinum toxin, and even stereotactic surgery. Management remains challenging, and there is a need for more innovative approaches for treatment.

Keywords

Musician Dystonia Botulinum toxin 

Supplementary material

Video 1

Shows the patient Musicians’ dystonia patient history on their first visit to the clinic. Task-specific flexion of the index finger is present when he plays and is improved by placing the thumb next to the index finger (a sensory trick) (MP4 94946 kb)

Video 2

Shows the patient Musicians’ dystonia patient history on their second visit to the clinic, 5 years later, without any treatment. Index finger dystonia has clearly worsened, with complete flexion of the finger into the hand when he plays. He demonstrates the highly task-specific nature of the disorder by imitating playing complex passages in the air without difficulty, only to experience immediate dystonic flexion the moment the hand touches the drum. 7.5 units of incobotulinum toxin type A was injected into the FDS of digit II, and 5 units of incobotulinum toxin type A was injected into the FDP of digit II at this visit (MP4 156746 kb)

Video 3

Two weeks later there is clear improvement Musicians’ dystonia patient history in dystonic flexion when he plays. 5 units of incobotulinum toxin type A was injected into the FDS of digit II at this visit (MP4 51617 kb)

Video 4

Two weeks later only a trace of dystonia Musicians’ dystonia patient history is evident, described by the patient in the video. 2.5 units of incobotulinum toxin type A were injected into the FDS of digit II at this visit (MP4 68606 kb)

Video 5

Six weeks after initial injection Musicians’ dystonia patient history, it shows a complete resolution of dystonia (MP4 51617 kb)

Suggested Reading

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.NYU School of MedicineNew YorkUSA

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