Focal dystonia in musicians: phenomenology, pathophysiology and triggering factors

Abstract

We propose a heuristic model that may explain the relatively high incidence of focal dystonia in musicians. This model assumes the coactions between a predominantly genetically determined predisposition and intrinsic and extrinsic triggering factors.

Diagnosis of Primary Task-Specific Lower Extremity Dystonia in a Runner

“…12,41 Task-specific dystonias have been associated with repetitive tasks, including sport-and instrument-specific activities that are prone to overuse and overpractice. 1 Increasing trends in running participation and high-mileage events may result in the right circumstances for increased observation of runner's dystonia. Further investigation is needed to accurately define the current prevalence of runner's dystonia.…”

“…1,5,18 By definition, primary dystonia includes dystonia without a known cause, whereas secondary dystonia includes physical or neurological trauma, medicinal or environmental toxicity, or psychogenic factors associated with the onset of dystonia. In the case presented here, a clear link to trauma or environmental or psychogenic factors cannot be made, but may have some association with the patient's symptoms and should be considered in the examination of a patient suspected of having dystonia.…”

“…18 Psychogenic characteristics that have been associated with dystonia include perfectionism, social phobias, and other specific phobias (acrophobia, claustrophobia, etc). 1 Psychological or potential traumatic findings should be considered in conjunction with the physical therapy examination.…”

Dystonia Arising from Occupations: The Clinical Phenomenology and Therapy

“…Usually these occur more frequently in males (2,(26)(27) and typically in the third to fourth decade of life. At least 1% of professional musicians are afflicted with dystonia (28).…”

“…About 10 -20% of task specific dystonias have a positive family history (30). Other risk factors such as increasing practice time, psychological stresses, anxiety, personality types have been implicated (27). At this point, the genetic underpinnings of focal hand dystonia, including that of musician's dystonia, have not yet been fully characterized.…”