The natural history of embouchure dystonia

Movement Disorders - Tập 16 Số 5 - Trang 899-906 - 2001
Steven J. Frucht1, Stanley Fahn1, Paul Greene1, Christopher F. O’Brien2, Michael H. Gelb3, Daniel Truong4, John Welsh3, Stewart A. Factor5, Blair Ford1
1Columbia-Presbyterian Medical Center. New York, New York USA
2Colorado Neurological Institute, Englewood, Colorado, USA
3New York University Medical Center, New York, New York USA
4Parkinson's and Movement Disorders Institute, Long Beach, California, USA
5Albany Medical College Albany, New York USA

Tóm tắt

AbstractFocal task‐specific dystonias are unusual disorders of motor control, often affecting individuals who perform complex repetitive movements. Musicians are especially prone to develop these disorders because of their training regimens and intense practice schedules. Task‐specific dystonia occurring in keyboard or string instrumentalists usually affects the hand. In contrast, there have been few descriptions of musicians with task‐specific dystonia affecting the muscles of the face and jaw. We report detailed clinical observations of 26 professional brass and woodwind players afflicted with focal task‐specific dystonia of the embouchure (the pattern of lip, jaw, and tongue muscles used to control the flow of air into a mouthpiece). This is the largest and most comprehensively studied series of such patients. Patients developed embouchure dystonia in the fourth decade, and initial symptoms were usually limited to one range of notes or style of playing. Once present, dystonia progressed without remission and responded poorly to oral medications and botulinum toxin injection. Patients with embouchure dystonia could be separated by the pattern of their abnormal movements into several groups, including embouchure tremor, involuntary lip movements, and jaw closure. Dystonia not infrequently spread to other oral tasks, often producing significant disability. Effective treatments are needed for this challenging and unusual disorder. © 2001 Movement Disorder Society.

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Tài liệu tham khảo

Tolosa ES, 1997, Movement disorders, 429

10.1212/WNL.39.2.192

10.1002/mds.870100418

10.1136/bmj.1.1365.441

Lederman RJ, 1988, Occupational cramp in instrumental musicians, Med Probl Perform Art, 3, 45

Knishkowy B, 1986, Instrumental musicians with upper extremity disorders: a follow‐up study, Med Probl Perform Art, 1, 85

Farkas P, 1962, The art of brass playing

10.1002/1531-8257(199901)14:1<171::AID-MDS1034>3.0.CO;2-1

10.1002/1531-8257(199909)14:5<883::AID-MDS1033>3.0.CO;2-1

10.1002/1531-8257(200003)15:2<348::AID-MDS1028>3.0.CO;2-7

Sheehy MP, 1988, Writer's cramp, Adv Neurol, 50, 457

10.1002/mus.880190403

10.1136/jnnp.50.3.291

Brandfondbrener AG, 1995, Musicians with dystonia: a report of 58 cases seen during a ten‐year period at a performing arts medicine clinic, Med Probl Perform Art, 10, 121

10.1002/mds.870110611

10.1093/brain/118.6.1461

10.1136/jnnp.65.5.722

10.1016/1350-4533(95)00006-9

10.1136/jnnp.39.12.1204

10.1001/archneur.1981.00510030041005

10.1016/S0140-6736(05)74865-0

10.1002/ana.410380603

10.1097/00001756-199811160-00006

10.1002/ana.410440520

10.1212/WNL.55.12.1869

10.1212/WNL.47.2.508

10.1002/1531-8257(199903)14:2<295::AID-MDS1015>3.0.CO;2-J

10.1016/S0894-1130(97)80070-1

10.1002/mds.870130321

10.1212/WNL.53.1.96

10.1002/1531-8249(200004)47:4<456::AID-ANA8>3.0.CO;2-Q

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Movement Disorders

Tập 16 Số 5

899-906

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