Hand Dystonia
Introduction[edit | edit source]
add text here relating to clinically relevant anatomy of the condition
Etiology[edit | edit source]
Genetic predisposition and environmental factors like repetitive stress in the form of frequent complex motor tasks have been associated with the pathogenesis of hand dystonia.[1]
Pathophysiology[edit | edit source]
There are multiple nervous system dysfunctions that have been identified in patients with hand dystonia. These include[1]:
Abnormal inhibitory mechanisms[edit | edit source]
Abnormal inhibition is seen at multiple levels of the nervous system which includes the lack of reciprocal inhibition, impaired intracortical inhibition in both hemispheres and dysfunction of the 'surround inhibition' mechanism (selective control of individual muscles by simultaneous inhibition of surrounding muscles).
Abnormal sensory function[edit | edit source]
At a given site, a history of pain or abnormal sensation commonly precedes the onset of motor symptoms. Abnormal sensory gating (modulation of sensory processing in response to movement) and somatotopic organization leads to abnormal sensorimotor integration.
Maladaptive plasticity[edit | edit source]
Uncontrolled plasticity reorganizes the cortical sensorimotor maps which gives rise to symptoms of hand dystonia
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
Electrodiagnostic tests are not diagnostic of hand dystonia. It is a purely clinical diagnosis.[2] This means that a diagnosis is made on the basis of clinically relevant history and physical examination.
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions[edit | edit source]
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Differential Diagnosis[edit | edit source]
The differential diagnosis of hand dystonia includes the following[2]:
- Neuropathies, radiculopathies or plexopathies of the upper extremity
- Complex regional pain syndrome
- Repetitive stress injury
- Focal seizures
- Thoracic outlet syndrome
- Effects of medication
- Psychogenic movement disorders
Resources[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ 1.0 1.1 Lin PT, Hallett M. The pathophysiology of focal hand dystonia. J Hand Ther. 2009 Apr-Jun;22(2):109-13; 114. doi: 10.1016/j.jht.2008.10.008
- ↑ 2.0 2.1 Torres-Russotto D, Perlmutter JS. Focal dystonias of the hand and upper extremity. J Hand Surg Am. 2008 Nov;33(9):1657-8. doi: 10.1016/j.jhsa.2008.09.001
