Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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Is Focal Dystonia a Central Nervous System Problem?

Mark Hallett
From: Medical Problems of Performing Artists: Volume 14 Number 1: Page 4 (March 1999)

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Abstract: One of the most feared disorders that can affect a professional musician is a focal dystonia of the hand.1,2 The disorder is also called an occupational cramp, or a cramp specific to the instrument, such as a pianist's cramp. The hand will not obey the will in carrying out skilled tasks and assumes abnormal postures. The problem can affect just a single digit or the whole arm. In most cases this occurs without pain, although muscle aching can occur if there have been many prolonged spasms. At least at first, no other skilled task of the hand is affected. Usually these disorders do not progress beyond the focal, task-specific problem, although sometimes they do generalize to other tasks or other parts of the body. Typically, the problem is chronic, and it is difficult to treat. Some of the symptoms look so unusual that physicians often think dystonic patients are hysterical. Studies of psychological function of these patients, however, has not revealed any disorder (other than some depression that is presumably reactive).3 Objective evidence indicates a disorder of motor function akin to more generalized dystonia.4-7 However, the cause of this malady remains unknown.

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