Task specific focal hand dystonia: Understanding the enigma and current concepts

摘要

Objective:The first step in approaching task specific focal hand dystonia (TSFHD) is recognition that it is a neurologicalndisorder and not a deficiency in practice or technique. To eliminate the enigma, TSFHD needs to be a more familiar entity. Thatnis the objective of this paper.nMethod: This is a state of the art review in concert with 3 decades of experience providing care for musicians written to act as anreference source. It is written as an introduction to TSFHD by reviewing history, etiology and current theories, presentation andncharacteristics, diagnosis and treatment.nConclusions: Information sources, both web-based and by consultation need to be accessible, reliable and comprehensive.nAccurate diagnosis should include the diagnosis of concurrent impairments and the confirmation that the diagnosis of TSFHD isncorrect. Successful treatment is likely to be interdisciplinary. Successful approaches may include the administration of botulinumntoxin but approaches should not be restricted to pharmaceuticals. Instrument modification, altering technique and sensory motornretraining are potential adjunctive approaches. A dichotomy exists between the therapeutic benefit achieved with treatment andnthe musician’s need for optimum hand function. The final goal is successful return to playing at a level that meets the musician’snneeds