Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist
Identifieur interne : 004272 ( Main/Merge ); précédent : 004271; suivant : 004273Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist
Auteurs : Joris N. A. L. Leijnse [États-Unis] ; Mark Hallett [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
A case study is presented in which a focal hand dystonia seems to have developed in the right hand of a classical guitarist as a result of a neuromuscular peripheral defect caused by trauma. The trauma was a near total perforation of the first web space by a splinter. Healing was uneventful without apparent functional complications. Two years later the patient noticed difficulties in extending the index in playing, for which he received various unsuccessful treatments during seven years. However, we found more severe dystonic symptoms (cocontractions) in the thumb than in the index during playing, which correlated with an undiagnosed insufficiency in the flexor pollicis brevis (FPB). This defect allowed proposing a biomechanical analysis of compensations for diminished thumb control in playing, which would explain the dysfunction in the index in playing as overcompensation for the thumb problem. If this analysis is correct, the etiology of the case can be traced back to underlying multiarticular control problems in the thumb caused by an insufficient FPB. This defect was considered irrepairable. It was concluded that even with knowledge of the underlying cause, a potentially successful treatment of the dystonia might not exist in this case. The case would demonstrate that task-specific hand dystonias can arise as overcompensations for (peripheral) neuro-musculoskeletal defects. The case is illustrated by videos of playing and functional thumb tests.
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Pascal:07-0491132Le document en format XML
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Leijnse</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Laboratory for Clinical Biomechanics and Reconstructive Surgery of Hand and Upper Limb, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Mechanical Engineering, Speed School for Engineering & Price Institute for Surgical Research, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Surgery, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation></author><author><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Human Motor Control Section, NINDS, National Institutes of Health</s1><s2>Bethesda, Maryland</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">07-0491132</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 07-0491132 INIST</idno><idno type="RBID">Pascal:07-0491132</idno><idno type="wicri:Area/PascalFrancis/Corpus">001530</idno><idno type="wicri:Area/PascalFrancis/Curation">001791</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001682</idno><idno type="wicri:doubleKey">0885-3185:2007:Leijnse J:etiological:musculo:skeletal</idno><idno type="wicri:Area/Main/Merge">004272</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist</title><author><name sortKey="Leijnse, Joris N A L" sort="Leijnse, Joris N A L" uniqKey="Leijnse J" first="Joris N. A. L." last="Leijnse">Joris N. A. L. Leijnse</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Laboratory for Clinical Biomechanics and Reconstructive Surgery of Hand and Upper Limb, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Mechanical Engineering, Speed School for Engineering & Price Institute for Surgical Research, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Surgery, University of Louisville</s1><s2>Louisville, Kentucky</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Kentucky</region></placeName></affiliation></author><author><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Human Motor Control Section, NINDS, National Institutes of Health</s1><s2>Bethesda, Maryland</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Biomechanics</term><term>Case study</term><term>Dystonia</term><term>Hand</term><term>Musician</term><term>Nervous system diseases</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Dystonie</term><term>Musicien</term><term>Main</term><term>Etude cas</term><term>Biomécanique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A case study is presented in which a focal hand dystonia seems to have developed in the right hand of a classical guitarist as a result of a neuromuscular peripheral defect caused by trauma. The trauma was a near total perforation of the first web space by a splinter. Healing was uneventful without apparent functional complications. Two years later the patient noticed difficulties in extending the index in playing, for which he received various unsuccessful treatments during seven years. However, we found more severe dystonic symptoms (cocontractions) in the thumb than in the index during playing, which correlated with an undiagnosed insufficiency in the flexor pollicis brevis (FPB). This defect allowed proposing a biomechanical analysis of compensations for diminished thumb control in playing, which would explain the dysfunction in the index in playing as overcompensation for the thumb problem. If this analysis is correct, the etiology of the case can be traced back to underlying multiarticular control problems in the thumb caused by an insufficient FPB. This defect was considered irrepairable. It was concluded that even with knowledge of the underlying cause, a potentially successful treatment of the dystonia might not exist in this case. The case would demonstrate that task-specific hand dystonias can arise as overcompensations for (peripheral) neuro-musculoskeletal defects. The case is illustrated by videos of playing and functional thumb tests.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Kentucky</li><li>Maryland</li></region></list><tree><country name="États-Unis"><region name="Kentucky"><name sortKey="Leijnse, Joris N A L" sort="Leijnse, Joris N A L" uniqKey="Leijnse J" first="Joris N. A. L." last="Leijnse">Joris N. A. L. Leijnse</name></region><name sortKey="Hallett, Mark" sort="Hallett, Mark" uniqKey="Hallett M" first="Mark" last="Hallett">Mark Hallett</name><name sortKey="Leijnse, Joris N A L" sort="Leijnse, Joris N A L" uniqKey="Leijnse J" first="Joris N. A. L." last="Leijnse">Joris N. A. L. Leijnse</name><name sortKey="Leijnse, Joris N A L" sort="Leijnse, Joris N A L" uniqKey="Leijnse J" first="Joris N. A. L." last="Leijnse">Joris N. A. L. Leijnse</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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