Musician's dystonia in a percussionist - clinical video analysis and botulinum toxin intervention: a case report.
Manuel Tomás Farinha Caroço, Ana Zão, Júlia Ribeiro and 3 others
PMID 38482971WHAT IT FOUND
After shockwave therapy, glucocorticoid injection, and medication trials did not relieve a percussionist's involuntary finger movements, a 10-unit botulinum toxin injection was followed by subjective 60% better conga playing at 4 weeks.
Benefit started to fade after 6 weeks. This is a single case, not proof.
Key findings
01The percussionist had involuntary left-hand finger movements and difficulty extending fingers while playing congas, but no deficits playing drums, and was diagnosed with musician's focal hand dystonia.
02After shockwave therapy, glucocorticoid injection, and medication trials did not relieve the movements, 10 units of botulinum toxin were injected into flexor digitorum superficialis fibres for the fourth finger.
03At 4 weeks, the patient reported subjective 60% improvement in performance ability, but benefits started to fade after 6 weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is a single case report, so it cannot show that botulinum toxin works for musician's focal hand dystonia. The improvement was reported as subjective 60% better performance. The patient had shockwave therapy, glucocorticoid injection, and medication trials before the injection, so the contribution of any single treatment cannot be separated. Follow-up after the first injection was described at 4 weeks, with fading after 6 weeks and reinjection at the 12th week. The splinting and sensory motor retuning ideas are from the discussion, not from the patient's treatment course.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not read the subjective 60% improvement at 4 weeks as proof that botulinum toxin treats musician's focal hand dystonia. This was a single case, the outcome was patient-reported, and the benefit was described as fading after 6 weeks.