Musician’s dystonia in a percussionist – clinical video analysis and botulinum toxin intervention: a case report

Authors

  • Manuel Tomás Farinha Caroço Physical and Rehabilitation Medicine Department, Hospital de Faro, Unidade Local de Saúde do Algarve, Faro, Portugal; Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal
  • Ana Zão Chronic Pain Unit and Physical and Rehabilitation Medicine Department, Hospital de Santo António, Unidade Local de Saúde de Santo António, Oporto, Portugal; Faculty of Medicine, University of Porto (FMUP), Oporto, Portugal; Center for Health Technology and Services Research and Health Research Network (CINTESIS@RISE), Oporto, Portugal; International Center of Arts Medicine, CUF Porto Institute, Oporto, Portugal
  • Júlia Ribeiro Physical and Rehabilitation Medicine Department, Hospital de Faro, Unidade Local de Saúde do Algarve, Faro, Portugal; Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal
  • Ana Fialho Physical and Rehabilitation Department, Hospital de Portimão, Unidade Local de Saúde do Algarve, Portimão, Portugal
  • Victor Milet Physical and Rehabilitation Medicine Department, Hospital de Faro, Unidade Local de Saúde do Algarve, Faro, Portugal; Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal
  • Bruna Meira Neurology Department, Hospital de Egas Moniz, Unidade Local de Saúde Lisboa Ocidental, Lisboa, Portugal

DOI:

https://doi.org/10.2340/jrm.v56.34877

Keywords:

botulinum toxins, case report, dystonia, focal, task-specific, electromyography, ultrasonography

Abstract

Objective: Musician’s focal hand dystonia is a painless task-specific focal dystonia, which presents with involuntary movements, abnormal postures, and loss of fine motor dexterity. We report here the case of a 63-year-old male, percussionist, with african ethnicity, with musician’s focal hand dystonia who was treated with botulinum toxin, and describe the results at 4-weeks follow up.

Methods: Clinical examination and video analysis revealed abnormal flexion of the 3rd finger, followed by flexion of the 4th and 5th fingers while playing the congas. Based on these findings, a diagnosis of musician's focal hand dystonia was established. Ten units of botulinum toxin were injected into the muscle fibres of the flexor digitorum superficialis corresponding to the 4th finger using electromyography and ultrasound guidance. Four weeks later, the patient reported a subjective 60% improvement in his performance. He emphasized the effect of botulinum toxin on performance speed and tension over the forearm and hand.

Conclusion: Botulinum toxin is not a definitive treatment for musician’s focal hand dystonia, but it may potentiate other definitive rehabilitation techniques. More research is needed to determine the long-term effects of botulinum toxin on function enhancement in musician’s focal hand dystonia.

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Published

2024-03-14

How to Cite

Farinha Caroço, M. T., Zão, A., Ribeiro, J., Fialho, A., Milet, V., & Meira, B. (2024). Musician’s dystonia in a percussionist – clinical video analysis and botulinum toxin intervention: a case report. Journal of Rehabilitation Medicine, 56, jrm34877. https://doi.org/10.2340/jrm.v56.34877

Issue

Vol. 56 (2024)

Section

Short Communication

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Copyright (c) 2024 Manuel Tomás Farinha Caroço, Ana Zão, Júlia Ribeiro, Ana Fialho, Victor Milet, Bruna Meira

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All digitalized JRM contents is available freely online. The Foundation for Rehabilitation Medicine owns the copyright for all material published until volume 40 (2008), as from volume 41 (2009) authors retain copyright to their work and as from volume 49 (2017) the journal has been published Open Access, under CC-BY-NC licences (unless otherwise specified). The CC-BY-NC licenses allow third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
From 2024, articles are published under the CC-BY licence. This license permits sharing, adapting, and using the material for any purpose, including commercial use, with the condition of providing full attribution to the original publication.

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