The natural history of embouchure dystonia
The natural history of embouchure dystonia
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DOI：
10.1002/mds.1167
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发表时间：
2001-09-01
影响因子：
8.6
通讯作者：
Ford, B
中科院分区：
文献类型：
--
作者：
Frucht, SJ;Fahn, S;Ford, B
局灶性任务特异性肌张力障碍是不常见的运动控制障碍，通常影响进行复杂重复运动的个体。由于音乐家的训练方案和紧张的练习时间表，他们特别容易患上这些疾病。在键盘或弦乐演奏者中发生的任务特异性肌张力障碍通常会影响手。相比之下，很少有关于音乐家患有任务特异性肌张力障碍影响面部和下巴肌肉的描述。我们报告了26名专业铜管乐器和木管乐器演奏者的详细临床观察结果，这些演奏者患有特定于特定任务的口部肌张力障碍（用于控制空气流入吹口的嘴唇，下巴和舌头肌肉的模式）。这是此类患者中最大和最全面的研究系列。患者在第四个十年发生口部肌张力障碍。最初的症状通常局限于一个音符范围或演奏风格。一旦出现，肌张力障碍进展无缓解，口服药物和肉毒杆菌毒素注射反应差。口唇肌张力障碍的患者可以根据其异常运动的模式分为几组，包括口唇震颤、不自主的嘴唇运动和下颌闭合。肌张力障碍经常会扩展到其他口腔任务，通常会造成严重的残疾。对于这种具有挑战性和不寻常的疾病需要有效的治疗。(C)2001运动障碍协会。
Focal task-specific dystonias are unusual disorders of motor control, often affecting individuals who perform complex repetitive movements. Musicians are especially prone to develop these disorders because of their training regimens and intense practice schedules. Task-specific dystonia occurring in keyboard or string instrumentalists usually affects the hand. In contrast, there have been few descriptions of musicians with task-specific dystonia affecting the muscles of the face and jaw. We report detailed clinical observations of 26 professional brass and woodwind players afflicted with focal task-specific dystonia of the embouchure (the pattern of lip, jaw, and tongue muscles used to control the flow of air into a mouthpiece). This is the largest and most comprehensively studied series of such patients. Patients developed embouchure dystonia in the fourth decade. and initial symptoms were usually limited to one range of notes or style of playing. Once present, dystonia progressed without remission and responded poorly to oral medications and botulinum toxin injection. Patients with embouchure dystonia could be separated by the pattern of their abnormal movements into several groups, including embouchure tremor, involuntary lip movements, and jaw closure. Dystonia not infrequently spread to other oral tasks, often producing significant disability. Effective treatments are needed for this challenging and unusual disorder. (C) 2001 Movement Disorder Society.