Focal task-specific dystonia of the musicians’ hand—a practical approach for the clinician

Narrative ReviewWatching a concert pianist perform a Chopin etude or a violin soloist perform a Paganini caprice, one cannot help but be awed by the miracle of motor control in man. These “athletes of the small muscles” are susceptible, however, to a condition known as focal, task-specific dystonia (FTSD), a disorder of motor control in which the hands that perform these exquisite maneuvers disobey their master's command. Affected patients offer a unique window to investigate motor learning and aberrant cerebral plasticity. Effective treatments including sensory rehabilitation and botulinum toxin injection offer real hope for symptomatic relief and also afford scientists the opportunity to investigate sensorimotor networks in the normal and abnormal state.