Focal Hand Dystonia Affecting Musicians. Part I: An Overview Of Epidemiology, PathoPhysiology And Medical Treatments

In 1911, Oppenheim coined the term ‘dystonia’ to describe disordered motor control, characterised by an association of hypotonia and tonic muscle spasm. Focal hand dystonia is one form of this disorder, in which symptoms are often task-specific and occur during skilled movements such as writing (writer's cramp) or playing a musical instrument (musician's cramp). Much research has been conducted on the pathophysiology of dystonia, but the underlying mechanisms still remain unclear. Hypotheseses about functional central nervous system alterations continue to gain more support. Scientific treatment-based publications on focal dystonia are sparse, and progress in evidence-based treatment options are necessary in order to assist this patient group. This paper will review the literature, documenting dystonia classification criteria, manifestations, pathophysiology and medical treatment techniques for musicians affected by focal hand dystonia.