Movement disorders in musicians

Abstract

The focus of this article is to review the epidemiology, phenomenology, pathophysiology, genetics, and treatment of movement disorders, particularly task-specific dystonia, in musicians. The goal is to draw attention to this group of neurological disorders among musicians, music teachers, and healthcare professionals and to highlight the importance of early diagnosis, therapeutic options, and preventive measures. To increase professional and public awareness and to facilitate the recognition of music-related neurological problems, we suggest that "medical problems of musicians" be included in curriculum of music schools and medical schools.

Etiology of musician’s dystonia

“…It is usually confined to a limb or embouchure. [1][2][3][4] The frequency of MD is estimated at about 1% among professional musicians; it is highly disabling and in many cases terminates performance careers. 1 While the pathophysiology remains largely elusive, MD has been associated with intensive training regimes and thus been considered a form of occupational cramp.…”

Rating scales for musician's dystonia

“…3,4 MD is the most common movement disorder affecting musicians. 5 Although prevalence estimates for FHD vary widely, depending on the study and geographic scope, 6 approximately 1% of musicians develop FHD, a rate about 10 times greater than for nonmusicians. 7 MD is usually associated with loss of fine control and coordination, most commonly in heterogeneous subsets of digits 2-5.…”

“…7 MD is usually associated with loss of fine control and coordination, most commonly in heterogeneous subsets of digits 2-5. 5,[8][9][10] The relative amount of excessive finger flexion or extension, 8,11 as well as which hand is affected, depends on the type of instrument. 8 Among the focal dystonias, MD exhibits some of the most exquisite task specificity.…”

“…15 It remains one of the primary challenges in musician's medicine [16][17][18] and is a particularly difficult form of dystonia to treat. 5,16 Anticholinergics are frequently not helpful. Botulinum toxin injections exhibit some efficacy but also several limiting adverse side effects, 5,8,19 particularly when lateral finger movements are an important part of the motor repertoire.…”

“…5,16 Anticholinergics are frequently not helpful. Botulinum toxin injections exhibit some efficacy but also several limiting adverse side effects, 5,8,19 particularly when lateral finger movements are an important part of the motor repertoire. In cases of comorbid ulnar neuropathy, surgical release procedures have shown mixed efficacy for the dystonia symptoms.…”