Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist
Identifieur interne : 001530 ( PascalFrancis/Corpus ); précédent : 001529; suivant : 001531Etiological 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 ; Mark HallettSource :
- 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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Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 07-0491132 INIST |
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ET : | Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist |
AU : | LEIJNSE (Joris N. A. L.); HALLETT (Mark) |
AF : | Laboratory for Clinical Biomechanics and Reconstructive Surgery of Hand and Upper Limb, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Department of Mechanical Engineering, Speed School for Engineering & Price Institute for Surgical Research, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Department of Surgery, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Human Motor Control Section, NINDS, National Institutes of Health/Bethesda, Maryland/Etats-Unis (2 aut.) |
DT : | Publication en série; Courte communication, note brève; Niveau analytique |
SO : | Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2007; Vol. 22; No. 12; Pp. 1803-1808; Bibl. 2 ref. |
LA : | Anglais |
EA : | 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. |
CC : | 002B17; 002B17H; 002B17C |
FD : | Système nerveux pathologie; Dystonie; Musicien; Main; Etude cas; Biomécanique |
FG : | Extrapyramidal syndrome; Mouvement involontaire; Muscle strié pathologie; Trouble neurologique; Encéphale pathologie; Système nerveux central pathologie |
ED : | Nervous system diseases; Dystonia; Musician; Hand; Case study; Biomechanics |
EG : | Extrapyramidal syndrome; Involuntary movement; Striated muscle disease; Neurological disorder; Cerebral disorder; Central nervous system disease |
SD : | Sistema nervioso patología; Distonía; Músico; Mano; Estudio caso; Biomecánica |
LO : | INIST-20953.354000143464810190 |
ID : | 07-0491132 |
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Pascal:07-0491132Le document en format XML
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<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>
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<ET>Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist</ET>
<AU>LEIJNSE (Joris N. A. L.); HALLETT (Mark)</AU>
<AF>Laboratory for Clinical Biomechanics and Reconstructive Surgery of Hand and Upper Limb, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Department of Mechanical Engineering, Speed School for Engineering & Price Institute for Surgical Research, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Department of Surgery, University of Louisville/Louisville, Kentucky/Etats-Unis (1 aut.); Human Motor Control Section, NINDS, National Institutes of Health/Bethesda, Maryland/Etats-Unis (2 aut.)</AF>
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<SO>Movement disorders; ISSN 0885-3185; Etats-Unis; Da. 2007; Vol. 22; No. 12; Pp. 1803-1808; Bibl. 2 ref.</SO>
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<EA>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.</EA>
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