Special Issue| Volume 22, ISSUE 2, P136-143, April 2009

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Focal task-specific dystonia of the musicians’ hand—a practical approach for the clinician

  • Steven J. Frucht
    Correspondence and reprint requests to S.J. Frucht, MD, Columbia University Medical Center, Department of Neurology, The Neurological Institute, 710 West 168th St, New York, NY 10032; Tel.: +1-212-305-0429; fax: +1-212-305-1304
    Columbia University Medical Center, Department of Neurology, The Neurological Institute, New York, NY
    Search for articles by this author
Published:March 09, 2009DOI:


      Narrative Review

      Watching a concert pianist perform a Chopin etude or a violin soloist perform a Paganini caprice, one cannot help but be awed by the miracle of motor control in man. These “athletes of the small muscles” are susceptible, however, to a condition known as focal, task-specific dystonia (FTSD), a disorder of motor control in which the hands that perform these exquisite maneuvers disobey their master's command. Affected patients offer a unique window to investigate motor learning and aberrant cerebral plasticity. Effective treatments including sensory rehabilitation and botulinum toxin injection offer real hope for symptomatic relief and also afford scientists the opportunity to investigate sensorimotor networks in the normal and abnormal state.
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      JHT Read for Credit

      Quiz: Article # 123

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue. There is only one best answer for each question.
      • #1.
        __________ is at the core of the potential to treat hand dystonia clinically
        • a.
          the determination of the patient
        • b.
          the determination of the therapist
        • c.
          the combined determination of the therapist and patient
        • d.
          cerebral placticity
      • #2.
        A review of the literature on FTSDmh revealed that
        • a.
          about 80% of cases had a predominate emotional involvement
        • b.
          about 20% of cases had bilateral involvement
        • c.
          about 80% of cases were male
        • d.
          about 50% of cases were female and 50% male
      • #3.
        The left hand was more often (than the right hand) involved in
        • a.
        • b.
          piano players
        • c.
          plucked string players
        • d.
      • #4.
        The onset of FTSDmh is typically seen
        • a.
          during skill acquisition
        • b.
          once motor skills have been acquired
        • c.
          during practice sessions, but not during live performance
        • d.
          during live performance, but not during practice sessions
      • #5.
        Most often FTSDmh
        • a.
          starts in multiple digits and does not spread to other digits
        • b.
          starts in a single digit and spreads to adjacent digits
        • c.
          starts in a single digit and spreads by skipping to a non-adjacent digit
        • d.
          starts in a single digit and spreads to the same digit in the opposite hand
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.