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Long‐term outcome of focal dystonia in string instrumentalists
Author(s) -
Schuele Stephan,
Lederman Richard J.
Publication year - 2004
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10647
Subject(s) - focal dystonia , dystonia , physical medicine and rehabilitation , violin , splint (medicine) , medicine , dysarthria , botulinum toxin , physical therapy , neurological disorder , muscle contracture , psychology , surgery , audiology , central nervous system disease , psychiatry , management , economics
This study describes the clinical characteristics and long‐term outcome in string instrumentalists with focal task‐specific dystonia. We present the results of a follow‐up telephone survey of 21 violin and viola players with focal dystonia. Eighteen musicians responded to the questionnaire. Information on long‐term outcome was available on average 13.8 years after onset of symptoms. Main complaints were playing‐related loss of control and involuntary movements affecting the fingering hand in 16 and the bow arm in 5 patients. In 18 patients (86%), signs of abnormal posture could be detected by watching them play their instrument. Treatment attempts included nerve decompression, physical therapy, retraining, and anticholinergic medication. In selected patients, botulinum toxin injections or splint devices were offered. Only 38% of the performing artists were able to maintain their professional careers, among them none with bow arm dystonia. Focal dystonia may affect the fingering hand or bow arm in violin and viola instrumentalists. Treatment benefit is limited and in more than half of the patients, dystonia leads to the end of their musical career. © 2003 Movement Disorder Society