Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over the past 10-15 years, there has been increasing interest in the health problems of performing artists. In this review, I will discuss the major playing-related disorders seen in instrumental musicians. Among the 672 instrumentalists evaluated, the major diagnoses identified included musculoskeletal disorders in 64%, peripheral nerve problems in 22.5%, and focal dystonia in 7%. Sixty percent of instrumentalists were female although males predominate in the group with focal dystonia. The average age of those evaluated was 32 years. Among musculoskeletal disorders overuse syndrome is the most common. Frequent peripheral nerve disorders include thoracic outlet syndrome, carpal tunnel syndrome, and ulnar neuropathy. A characteristic distribution of symptoms and signs is identified for each instrument group. Electrodiagnostic studies are an important part of the evaluation of these disorders. With carefully designed treatment, the majority of instrumental musicians can be returned to full and pain-free playing activities. The success rate is highest in some entrapment neuropathies but remains low in focal dystonia.
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PMID:AAEM minimonograph #43: neuromuscular problems in the performing arts. 819 98

A patient affected by thoracic outlet syndrome, with an involvement of the left lower primary trunk due to a rudimentary cervical rib, developed a severe hand dystonia on the same side. The dystonic posture was characterised by a flexion of the wrist with the fingers curled into the palm. Polygraphic recordings performed on the left flexor digitorum superficialis (FDS4) and extensor digitorum superficialis (EDC4) muscles, during a repetitive tapping task of the fourth digit, showed a loss of well formed bursts without a clear silent period along with long duration bursts of cocontraction in antagonistic muscles. The study of reciprocal inhibition between forearm flexor and extensor muscles showed a reduced amount of inhibition in both the disynaptic and the later presynaptic phase of inhibition. The patient underwent an operation with resection of the cervical rib. Twelve hours after the operation the patient experienced a significant improvement of the hand dystonia; the distonia had disappeared completely by two months with a progressive normalisation of reciprocal inhibition.
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PMID:Focal hand dystonia in a patient with thoracic outlet syndrome. 970 90

In the last two decades, injuries to instrumental musicians have been well documented. Major categories of performance-related injuries include musculoskeletal overuse, nerve entrapment/thoracic outlet syndrome, and focal dystonia. Other areas of concern to instrumentalists include hypermobility, osteoarthritis, fibromyalgia, and hearing loss. This chapter reviews the epidemiology, risk factors, physical exam, treatment, and prevention of common problems of instrumentalists. Emphasis is placed on the team approach of treatment and prevention and the need for close collaboration of the various health professionals, music educators, and performers. Additional resources are presented for those interested in pursuing performing arts medicine in greater detail.
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PMID:Instrumental musicians' hazards. 1156 22

Over the past 20 years, there has been increasing interest in the medical problems of performing artists. In this review, the major playing-related disorders seen in instrumental musicians are discussed. Among the 1353 instrumentalists personally evaluated, the major diagnoses included musculoskeletal disorders in 64%, peripheral nerve problems in 20%, and focal dystonia in 8%. Of these instrumentalists, 60% were women, although men were the majority in the group with focal dystonia. The average age at the time of evaluation was 37 years for men and 30 years for women. Among musculoskeletal disorders, regional muscle pain syndromes, particularly of the upper limb, upper trunk, and neck, were most common. Specific entities such as tendinitis and ligament sprain were less common. Frequent peripheral nerve disorders included thoracic outlet syndrome, ulnar neuropathy at the elbow, and carpal tunnel syndrome. Each instrument group showed a characteristic distribution of symptoms and signs that appeared to be directly related to the static and dynamic stresses inherent in the playing of the instrument. Electrodiagnostic studies are an important part of the evaluation of these disorders, particularly nerve entrapment syndromes. With carefully designed treatment, the majority of instrumental musicians can return to full and pain-free playing. Nerve entrapment syndromes have the highest treatment success rate, followed by musculoskeletal pain syndromes. Despite some recent innovative approaches, focal dystonia remains largely resistant to therapy.
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PMID:Neuromuscular and musculoskeletal problems in instrumental musicians. 1270 74

148 musicians (81 females, mean age 33.8 years) visited the senior hand surgeon's office due to disorder of an upper extremity. They had started playing at mean age of 8.6 years and did play mean 2.4 hours a day. One third were string players, and piano was the main instrument in 21%. The area of disorder was hand and wrist in 57%, forearm in 19%, and arm in 18%. Pain was the main complaint in 64%. Most of the musicians (87%) had consulted earlier another doctor and they already had a diagnosis, mostly some kind of tendonitis. However, in a half of them the diagnosis was changed. The most common diagnosis given by the hand surgeon was thoracic outlet syndrome, TOS. Those patients' earlier diagnosis was mostly tendinitis. Playing-related musculoskeletal disorders were counted in 14%, hypermobility syndrome in 8%, and focal dystonia in 5%. In 5 patients, hand surgeon was unable to make any relevant diagnosis. Only 16 patients (11%) needed surgical treatment.
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PMID:[Musicians consulting a hand surgeon having special competence in musician's medicine. A survey of 148 patients]. 2126 9

Botulinum toxin (BTX) is used for multiple clinical indications due to its ability to induce temporary chemodenervation and muscle paralysis. This property has supported its application in treating a variety of musculoskeletal conditions, especially those involving muscular hyperactivity and contractures such as cerebral palsy and dystonia. However, off-label use of BTX injection in other musculoskeletal disorders is gaining increased acceptance, such as in neurogenic thoracic outlet syndrome, epicondylitis, and shoulder pain after stroke. This review discusses the mechanism of action, best practices, and current indications of BTX injections in the musculoskeletal system. We also discuss the state of the science regarding BTX injections for musculoskeletal disorders and the available evidence supporting its use.
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PMID:Botulinum Toxin Injections in Musculoskeletal Disorders. 2800 66