Zusammenfassung
Unter den Dystonien spielt die Gruppe der aktionsbezogenen Dystonien wegen der spezifischen
pathogenetischen Aspekte eine Sonderrolle. Neben dem häufigen Graphospasmus sind bislang
vor allem Musikerspasmen und seltener andere berufsspezifische Handdystonien beschrieben
worden. Aktionsinduzierte Handdystonien bei Sportlern werden sehr selten erwähnt;
die Veröffentlichungen dazu betreffen bislang lediglich Golf-, Billard-, Dart- und
Tennisspieler. Vorgestellt wird der Fall eines 35-jährigen Patienten mit einer aktionsinduzierten
Handdystonie bei einem Sportschützen. Die Dystonie konnte erfolgreich mit Botulinumtoxin
A behandelt werden, so dass er an die sportliche Höchstleistung vor Auftreten der
Dystonie anknüpfen konnte.
Abstract
Because of specific pathogenetic aspects, the group of action-related dystonias represents
a special variety among the dystonias. In addition to frequent cases of graphospasms,
musicians' spasms, above all, and, less frequently, other occupational dystonias of
the hand have been described. There are only very rare reports of action-induced dystonias
of the hand in athletes. To date, publications concern but golfers, billiard, dart
and tennis players. The case of a 35-year-old patient with action-induced dystonia
of the hand in an archer is presented. The dystonia was successfully treated with
botulinum toxin A enabling the patient to regain his record performance achieved prior
to the occurrence of the dystonia.
Literatur
- 1
Ferguson D.
An Australian study of telegraphist's cramp.
Br J Med.
1971;
28
280-285
- 2
Sheehy M P, Marsden C D.
Writer's cramp - a focal dystonia.
Brain.
1982;
105
461-480
- 3 Watts R L, Koller W C. Movement Disorders. New York; McGraw-Hill 1996
- 4
Mayer F, Topka H, Boose A. et al .
Bilateral segmental dystonia in a professional tennis-player.
Med Sci Sports Exerc.
1999;
31
1085-1087
- 5
Cohen A.
Putting on the agony.
Nurs Mirror Midwives J.
1976;
143
72
- 6
Smith A M, Malo S A, Laskowski E R. et al .
A multidisciplinary study of the „yips” phenomen in golf: An exploratory analysis.
Sports Med.
2000;
30
423-437
- 7
McDaniel K D, Cummings J L, Shain S.
The „yips”: a focal dystonia of golfers.
Neurology.
1989;
39
192-195
- 8
Grafman J, Cohen L G, Hallett M.
Is focal hand dystonia associated with psychopathology?.
Mov Disord.
1991;
6
29-35
- 9
Friedman J R, Klein C, Leung J. et al .
The GAG deletion of the DYT1 gene is infrequent in musicians with focal dystonia.
Neurology.
2000;
55
1417-1418
- 10
Leijne J N.
Anatomical factors predisposing to focal dystonia in the musician's hand - principles,
theoretical examples, clinical significance.
J Biomech.
1997;
30
659-669
- 11
Charness M E, Ross M H, Shefner J M.
Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: clinical correlation
in musicans.
Muscle Nerve.
1996;
16
431-437
- 12
Quartarone A, Girlanda P, Risitano G. et al .
Focal hand dystonia in a patient with thoracic outlet syndrome.
J Neurol Neurosurg Psychiatry.
1998;
65
272-274
- 13
Byl N N, McKenzie A.
Treatment effectiveness for patients with a history of repetitive hand use and focal
hand dystonia: a planned, prospective follow-up study.
J Hand Ther.
2000;
13
289-301
- 14
Cole R, Hallett M, Cohen L G.
Double-blind trial of botulinum toxin for treatment of focal hand dystonia.
Mov Disord.
1995;
10
466-471
- 15
Behari M.
Botulinum toxin in the treatment of writer's cramp.
J Assoc Physicians India.
1999;
47
694-698
- 16
Newmark J, Hochberg F H.
Isolated painless manual incoordination in 57 musicians.
J Neurol Neurosurg Psychiatry.
1987;
50
291-295
- 17 Fahn S, Marsden C D, DeLong M R. Dystonia 3. Advances in Neurology. Philadelphia,
New York; Lippincott-Raven 1998 Vol 78
Prof. Dr. G. Reichel
Paracelsusklinik
Werdauer Straße 68
08060 Zwickau
Email: Prof.Reichel@t-online.de
