Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, US.
Department of Neurology, University of Maryland School of Medicine, US.
Tremor Other Hyperkinet Mov (N Y). 2021 Feb 8;11:6. doi: 10.5334/tohm.577.
Reports of drummers' dystonia are rare, particularly compared to the literature on dystonia in string, piano and brass players. Several cases of drummers' dystonia have been included in large series of multiple instrumentalists, but there are few reports comprised exclusively of drummers with musicians' dystonia. We present here a series of 12 drummers with task-specific, focal dystonia affecting their upper limbs while drumming and spanning multiple playing techniques and musical styles.
We conducted a retrospective chart review of drummers with dystonia seen at academic Movement Disorders centers.
All 12 patients were male, and the majority eventually developed spread of dystonia to tasks other than drumming. Ten of the 12 had dystonia affecting their fingers, while 8/12 had dystonia affecting the wrist. Only 1/12 had involvement proximal to the wrist. Pharmacologic interventions were largely ineffective; 3 had some benefit from botulinum toxin injections, but this was limited by problematic weakness in one drummer.
The phenomenology in our series is concordant with prior reported cases, demonstrating frequent wrist involvement, though we also found that a greater proportion of patients had dystonia affecting the fingers. It could be hypothesized that different drumming techniques or musical styles modulate the relative risk of dystonic involvement of the different anatomical regions of the upper limb.
Drummers' dystonia is one of the least common forms of musicians' dystonia, though this may reflect fewer numbers of these instrumentalists. We present the largest series of drummers' dystonia and review previously published cases. Our cohort, representing diverse drumming styles, showed frequent involvement of dystonia in the wrists and fingers.
鼓手痉挛的报告很少见,与弦乐、钢琴和铜管乐器演奏者的痉挛文献相比更是如此。一些鼓手痉挛的病例被纳入了多种乐器演奏者的大型系列中,但仅有少数报告专门包含有痉挛的鼓手。我们在此介绍 12 名鼓手的系列病例,他们在演奏时上肢出现特定于任务的局灶性痉挛,涉及多种演奏技术和音乐风格。
我们对在学术运动障碍中心就诊的患有痉挛的鼓手进行了回顾性图表审查。
所有 12 名患者均为男性,大多数最终发展为除了击鼓以外的任务上的痉挛扩散。12 人中的 10 人手指痉挛,而 8/12 人手腕痉挛。只有 1/12 人手腕以上部位受累。药物干预效果大多不理想;3 人接受肉毒杆菌毒素注射后有一定效果,但其中一名鼓手因肌肉无力而受限。
我们系列中的现象学与之前报道的病例一致,表明手腕频繁受累,但我们也发现更多的患者手指痉挛。可以假设不同的击鼓技术或音乐风格会调节上肢不同解剖区域出现痉挛的相对风险。
鼓手痉挛是音乐家痉挛中最不常见的形式之一,尽管这可能反映出这类乐器演奏者较少。我们呈现了最大的鼓手痉挛系列病例,并回顾了以前发表的病例。我们的队列代表了不同的击鼓风格,显示出频繁的手腕和手指痉挛。