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Progression of idiopathic focal dystonia may be explicable on the basis of abnormal muscle spindle properties during muscle fatigue
Development of dystonia of the hand may be devastating to the professional musician or sportsperson. The results of EMG guided botulinum toxin treatment of arm dystonia may be disappointing or associated with unacceptable adverse effects, and the clinical skills required to undertake it are not universally available.
Our understanding of the natural history and pathophysiology of focal dystonias remains incomplete. Dystonia is not spasm or over activity of a single muscle or muscle group. In this issue of J Neurol Neurosurg Psychiatry, Rosset-Llobet and colleagues1 describe the characteristics of dystonia in 101 musicians (see page 949). They highlight that …