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Focal Task-Specific Dystonia Induced by Peripheral Trauma

 
 

Copyright 2017, Mark Alan Wade

Primary Author: Frucht, S.
Journal Title: Movement Disorders
Date Published: Mar-00
Language: English
Category: Nervous Disorders
Key Words: dystonia medical musician instrumental task focal trauma
Full Citation: Frucht, Steven, Stanley Fahn, and Blair Ford. Focal Task-specific Dystonia Induced by Peripheral Trauma. Movement Disorders 15, no. 2 (March 2000): 348-50.
Full Abstract: First described by Gowers over a century ago, examples of focal task-specific dystonias (FTSDs) include telegrapher's cramp, writer's cramp, golfer's cramp (the yips), and musician's cramps. By definition, FTSD affects one part of the body exclusively during the performance of a specific task. FTSD may be the first sign of a generalized dystonia, before spread to other tasks or other parts of the body. However, in the overwhelming majority of patients with FTSD, dystonia remains confined to the body part and the specific task in which it started. There is considerable debate regarding the role of peripheral trauma in triggering dystonia. Cervical dystonia, shoulder dystonia, and dystonia of the arm and leg have been reported following local trauma. Recent work in primates and humans supports the idea that FTSDs may result from alterations in normal cortical topography. Although the etiology of these disorders is unknown, the idea has been proposed that in a susceptible population, FTSD may be triggered by peripheral trauma. We report two unusual patients, both musicians, who developed FTSD after peripheral trauma. In both instances, dystonia was temporally and anatomically linked to the peripheral injury. Although the trauma was not severe, dystonia was professionally debilitating, and in one case continued to progress long after the trauma had healed.