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Review

Botulinum Toxin Therapy in Writer’s Cramp and Musician’s Dystonia

1
Department of Neurology, New York University Grossman School of Medicine, New York, NY 10017, USA
2
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
*
Author to whom correspondence should be addressed.
Toxins 2021, 13(12), 899; https://doi.org/10.3390/toxins13120899
Submission received: 9 November 2021 / Revised: 10 December 2021 / Accepted: 10 December 2021 / Published: 14 December 2021
(This article belongs to the Special Issue Botulinum Toxin in the Movement Disorders Clinic: State of the Art)

Abstract

Task-specific focal dystonia is characterized by muscle contraction(s) during a specific task, resulting in abnormal postures or movements. Specifically, writer’s cramp involves the upper extremity during the act of writing. Musician’s dystonia has a highly variable presentation, and thus makes therapeutic options more limited. Treatments include oral pharmacologic agents, neuromodulation, surgery and, most often, botulinum toxin (BoNT) injection. Selection of target muscles for toxin injection continues to be an area of active research for these task-specific movements. We present a review of the literature selected from a predefined search of the MEDLINE and ClinicalTrials.gov databases. We include six controlled studies of botulinum toxin for the management of writer’s cramp and focal task-specific dystonia (FTSD), including musician’s dystonia. Overall, 139 patients were included across all studies, with 99 individuals injected for writer’s cramp and the remaining 40 individuals with FTSD. The age range of all patients was 18–80 years old. We included studies that utilized only the BoNT-A serotype. These studies utilized various severity scales to quantify response to toxin injection, with ratings of instrument or pen control included as subjective ratings. Of the included 139 patients in this review, pooled data for toxin response show that 73% of patients who received the drug demonstrated improvement. Specific techniques for muscle localization and targeting were difficult to study as variable methods were employed. This remains an area of ongoing exploration.
Keywords: writer’s cramp; task-specific dystonia; botulinum toxin; musician’s dystonia writer’s cramp; task-specific dystonia; botulinum toxin; musician’s dystonia

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MDPI and ACS Style

Zakin, E.; Simpson, D.M. Botulinum Toxin Therapy in Writer’s Cramp and Musician’s Dystonia. Toxins 2021, 13, 899. https://doi.org/10.3390/toxins13120899

AMA Style

Zakin E, Simpson DM. Botulinum Toxin Therapy in Writer’s Cramp and Musician’s Dystonia. Toxins. 2021; 13(12):899. https://doi.org/10.3390/toxins13120899

Chicago/Turabian Style

Zakin, Elina, and David M. Simpson. 2021. "Botulinum Toxin Therapy in Writer’s Cramp and Musician’s Dystonia" Toxins 13, no. 12: 899. https://doi.org/10.3390/toxins13120899

APA Style

Zakin, E., & Simpson, D. M. (2021). Botulinum Toxin Therapy in Writer’s Cramp and Musician’s Dystonia. Toxins, 13(12), 899. https://doi.org/10.3390/toxins13120899

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