一位打击乐演奏家的音乐家手痙攣 - 臨床視頻分析與肉毒桿菌毒素干預：病例報告。

Musician's dystonia in a percussionist - clinical video analysis and botulinum toxin intervention: a case report.

机构信息

Physical and Rehabilitation Medicine Department, Hospital de Faro, Unidade Local de Saúde do Algarve, Faro, Portugal; Algarve Biomedical Center Research Institute (ABC-RI), Faro, Portugal.

Chronic Pain Unit and Physical and Rehabilitation Medicine Department, Hospital de Santo António, Unidade Local de Saúde de Santo António, Oporto, Portugal; Faculty of Medicine, University of Porto (FMUP), Oporto, Portugal; Center for Health Technology and Services Research and Health Research Network (CINTESIS@RISE), Oporto, Portugal; International Center of Arts Medicine, CUF Porto Institute, Oporto, Portugal.

出版信息

J Rehabil Med. 2024 Mar 14;56:jrm34877. doi: 10.2340/jrm.v56.34877.

DOI:10.2340/jrm.v56.34877

PMID:38482971

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10953829/

Abstract

OBJECTIVE

Musician's focal hand dystonia is a painless task-specific focal dystonia, which presents with involuntary movements, abnormal postures, and loss of fine motor dexterity. We report here the case of a 63-year-old male, percussionist, with african ethnicity, with musician's focal hand dystonia who was treated with botulinum toxin, and describe the results at 4-weeks follow up.

METHODS

Clinical examination and video analysis revealed abnormal flexion of the 3rd finger, followed by flexion of the 4th and 5th fingers while playing the congas. Based on these findings, a diagnosis of musician's focal hand dystonia was established. Ten units of botulinum toxin were injected into the muscle fibres of the flexor digitorum superficialis corresponding to the 4th finger using electromyography and ultrasound guidance. Four weeks later, the patient reported a subjective 60% improvement in his performance. He emphasized the effect of botulinum toxin on performance speed and tension over the forearm and hand.

CONCLUSION

Botulinum toxin is not a definitive treatment for musician's focal hand dystonia, but it may potentiate other definitive rehabilitation techniques. More research is needed to determine the long-term effects of botulinum toxin on function enhancement in musician's focal hand dystonia.

摘要

目的

音乐家手部局限性肌张力障碍是一种无痛的任务特异性局限性肌张力障碍，表现为不自主运动、姿势异常和精细运动灵巧度丧失。我们在此报告一例 63 岁男性、打击乐演奏者、非裔，患有音乐家手部局限性肌张力障碍，接受了肉毒毒素治疗，并描述了 4 周随访时的结果。

方法

临床检查和视频分析显示在演奏康茄鼓时，第 3 指出现异常弯曲，随后第 4 指和第 5 指弯曲。根据这些发现，诊断为音乐家手部局限性肌张力障碍。使用肌电图和超声引导，将 10 个单位的肉毒毒素注射到第 4 指的屈指浅肌纤维中。4 周后，患者报告说他的表现主观上有 60%的改善。他强调了肉毒毒素对演奏速度和前臂及手部张力的影响。