Focal hand dystonia in musicians: a synopsis.

Focal hand dystonia in musicians (FHDM), also known as 'musicians' cramp', is a relatively rare, task-specific, pain-free disorder of control, causing unintentional, abnormal movements and/or positions in a part of the body directly involved in playing a musical instrument. Few physicians are familiar with the diagnosis, yet the exact cause of the disorder remains unknown and there is no generally effective therapy. In this synopsis, the authors present their experience with the diagnosis and treatment of FHDM and their aetiology hypothesis that musicians' cramp is caused by a loss of central motor control initiated by a failure of coping mechanisms, which (try to) compensate for the effects of peripheral local movement disturbing factors in the hand. Recent publications focus on the role of the central nervous system and on motor pattern relearning. We recommend further (prospective) research of the results of operative (peripheral) therapy, followed by (central) motor pattern relearning, and of neuropsychological contributions.