Focal dystonia

The focal dystonia (Greek δυσ - dys - ' miss- ', τόνος Tonos ' voltage ' ) is one of the more common neurological disorders and manifests itself in uncontrollable and often long-lasting muscle contractions. The disturbance is local and mostly affects regions that perform complex movements with extreme precision.

General

Focal dystonia is also known as musician's cramp or employment neurosis. However, this refers to a special form of the disease, the action-specific focal dystonia ( also members dystonia), which include, among other things, the writer's cramp counts.

This form of dystonia is characterized in that, although the musculoskeletal system in general is intact, but not when performing a learned movement such as the Zupfbewegung on the guitar or the stop motion at the piano, the fingers or hand in the situation, this movement to perform, while the same movement without an instrument or in a different context often runs completely trouble free.

The causes that lead to disease are not known. However, it is presumed that a dysfunction of the unconscious regulation of motor activity in the basal ganglia in the brain. According to one theory, the individual centers the figure in the motor cortex are enlarged to the extent that the regions overlap and thus adjacent motor functions are triggered. The middle finger is supposed to move, but with the ring finger is actuated, the ring finger is called back again, at the same time controls the middle finger, and thus creating a vicious circle of movement initiation and inhibition.

Other forms of Focal dystonia are:

  • Cervical dystonia ( torticollis / spasmodic torticollis )
  • Blepharospasm ( eyelid spasm )
  • Spasmodic dysphonia ( vocal cord spasm )
  • Oromandibular dystonia ( oral tongue, throat spasm )

Frequency

For musicians, the disease rate is 1:200 to 1:500, with other professionals such as surgeons or precision engineers at 1:3400 cases per year. Projected to the total population, this 2.4 are per 100,000 population.

Therapy and prophylaxis

These therapies are usually applied:

  • Delivery of botulinum toxin. This agent can be injected into specific muscle regions, inhibits the overly strong muscle traction, resulting in motor activity to a "normal ". However, the treatment must be repeated regularly as after removal of the agent in the body ( about 3 months), the effect wears off. Sometimes this repetition leads to the formation of antibodies, which suggests a further treatment will have no effect.
  • Retraining: Targeted exercises it is possible to desensitize the misdirected motor skills and to calibrate the new motor.
  • A combination of both therapies: Under delivery of Botox and a retraining therapy.

Since the causes of focal dystonia is not known, a targeted prevention is not possible.

Forecast

In approximately 10-20 % of patients there is a decrease in symptoms. This takes place mostly within the first three years. However, a recurrence of symptoms is possible.

In the other patients, a slow deterioration within three to five years is common to then transition to a stable situation.

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