MovDisordV3, PascalFrancis, Curation, bibRecord, 001791

Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist

Identifieur interne : 001791 ( PascalFrancis/Curation ); précédent : 001790; suivant : 001792

Etiological 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.

RBID : Pascal:07-0491132

Descripteurs français

Pascal (Inist)
- Système nerveux pathologie, Dystonie, Musicien, Main, Etude cas, Biomécanique.

English descriptors

KwdEn :
- Biomechanics, Case study, Dystonia, Hand, Musician, Nervous system diseases.

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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A11	`02`	`1`		`@1 HALLETT (Mark)`
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C07	`02`	`X`	`FRE`	`@0 Mouvement involontaire @5 38`
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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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   |texte=   Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist
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	Movement Disorders (revue)
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Movement Disorders (revue)

Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist

Etiological musculo-skeletal factor in focal dystonia in a musician's hand : A case study of the right hand of a guitarist

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