Focal dystonia

Original Editor - Carlos Areia

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Search Strategy
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Keywords: Focal dystonia - physiotherapy

Introduction
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Dystonia is defined as an involuntary contraction of the agonistic and antagonistic muscles, which can lead to repetitive involuntary movements and/or abnormal positions, most common in the hand (known as Focal Hand Dystonia). The affected population includes individuals who require repetitive movements on their regular daily life; one of the most affected populations are the musicians and professional writers [1]. In the European and American population Focal dystonia varies its prevalence between 3 and 29.5 per 100.000 inhabitants [1][2]. Inside musicians dystonia it is estimated that of all musicans, 0.5 % to 1% suffer from some form of focal dystonia [1][3]. This figures are highly variables if we individualize each case, depending on the instrument and the effort required on each performance; for instance the difference between a rhythm and a soloist guitar player.

Mechanism of Injury / Pathological Process
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Although the pathological process of Focal Dystonia is still classified as idiopathic, increasing evidence suggested a multifactorial etiology (e.g. [4] interaction between genetic, neuromuscular, auditory, neural adaptative, anatomic, stressful, repetitive, psychosocial, traumatic, among others). 

Clinical Presentation[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

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Management / Interventions
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Botulin Toxin [5]

Surgery 

Differential Diagnosis
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Key Evidence[edit | edit source]

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Resources
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Case Studies[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. 1.0 1.1 1.2 Aranguiz, R., Chana-Cuevas, P., Alburquerque, D., & Leon, M. (2011). Focal dystonia in musicians. Neurologia, 26(1), 45-52. doi: 10.1016/j.nrl.2010.09.019
  2. Defazio, G., Abbruzzese, G., Livrea, P., & Berardelli, A. (2004). Epidemiology of primary dystonia. Lancet Neurol, 3(11), 673-678. doi: 10.1016/s1474-4422(04)00907-x
  3. Jabusch, H. C., Zschucke, D., Schmidt, A., Schuele, S., & Altenmuller, E. (2005). Focal dystonia in musicians: treatment strategies and long-term outcome in 144 patients. Mov Disord, 20(12), 1623-1626. doi: 10.1002/mds.20631
  4. Byl, N. N., Archer, E. S., & McKenzie, A. (2009). Focal hand dystonia: effectiveness of a home program of fitness and learning-based sensorimotor and memory training. J Hand Ther, 22(2), 183-197; quiz 198. doi: 10.1016/j.jht.2008.12.003
  5. Ceballos-Baumann, A. O., Sheean, G., Passingham, R. E., Marsden, C. D., & Brooks, D. J. (1997). Botulinum toxin does not reverse the cortical dysfunction associated with writer's cramp. A PET study. Brain, 120 ( Pt 4), 571-582.