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Dystonia in Musicians


Copyright 2024, Mark Alan Wade

Primary Author: Jankovic, J.
Journal Title: Seminars in Neurology
Date Published: Jun-89
Language: English
Category: Nervous Disorders
Key Words: dystonia musician focal treatment
Full Citation: Jankovic, Joseph, and Heidi Shale. Dystonia in Musicians. Seminars in Neurology 9, no. 2 (June 1989): 131-5.
Full Abstract: Musicians are subject to a number of treatable medical problems, such as over-use syndrome, tendonitis, and nerve entrapment. One medical problem remains elusive: focal dystonia. The epidemiology of dystonia in musicians has not been well studied. The five categories of dystonia are: focal, multifocal, segmented, hemidystonia, and generalized dystonia. Focal dystonia is accompanied by a blepharospasm, oculogyric deviations, oromandibular and lingual dystonia, torticollis, foot dystonia, and task dystonia, such as writer's cramp. The etiology of focal dystonias in musicians is classified as peripheral and central. Peripheral dystonias are caused by nerve entrapment and overuse injuries in combination. This disorder manifested itself in the upper lip and fingers respectively in the trumpeters with focal dystonia in this study. Possible causes include peripheral trauma through overuse, nerve entrapment, change of technique or instrument, genetic predisposition and unusual emotional stress. Other research suggests that task specific focal dystonia possibly results from abnormal sensory feedback to the supplementary motor area of the brain. Treatment begins with a proper diagnosis. Rehabilitation includes resting, the use of ice, nonsteroidal inflammatory agents, topical 10% trolamine slicylate (Aspercreme), stretching and strengthening exercises, and the correction of faulty technique. Anticholinergic drugs, carbamazepine, propranolol, primidone, diazepam and tetrabenazine may be used on musicians with idiopathic or inherited focal dystonia.