What is the Cause? Scientists believe dystonia symptoms What is Hand Dystonia? result from improper signals in the nervous Dystonia is a movement disorder system that cause muscles to contract characterized by uncontrollable muscle involuntarily. Researchers and doctors do contractions that cause involuntary, Focal Hand Dystonia not yet fully understand the neurological often repetitive, body movements (Writer’s Cramp) mechanisms that cause this abnormal and/or postures. To learn more about dystonia muscle contraction. DYSTONIA OF THE HAND and the DMRF, contact: AND FINGERS Focal hand dystonia is a specific form Dystonia Medical Most cases of hand dystonia represent characterized by excessive, involuntary Research Foundation isolated dystonia, meaning that there are muscle contractions in the fingers, One East Wacker Drive, Suite 1730 no identifiable causes for the dystonic hand , forearm, and sometimes shoulder. Chicago, Illinois 60601-1980 symptoms. Hand dystonia may occur in Symptoms usually appear when a person Phone: 312-755-0198 conjunction with early onset generalized is doing a task that requires fine motor Toll free: 800-377-DYST (3978) dystonia, which affects the limbs and coordination of hand and arm muscles. Email: [email protected] multiple muscle groups simultaneously. Web: www.dystonia-foundation.org Isolated hand dystonia occurs mainly in Hand dystonia includes a group of Connect with the DMRF on Facebook, Twitter, and YouTube. patients with no family history of the disorders called occupational hand disorder. Only 5-25% of individuals dystonias that affect musicians, golfers, Special thanks to Aleksandar Videnovic, MD, MSc have a family history of dystonia. or typists. The symptoms often occur for reviewing this publication. only during a specific activity requiring Hand dystonia may be acquired as a use of the hand, such as playing an consequence of injury, peripheral nerve instrument, golfing, or typing. Writer’s damage, or spinal cord lesions. Symptoms cramp is a dystonia that is present when of acquired hand dystonia may persist a person is writing. Hand dystonia may even when the hand is at rest, there may occur as an isolated focal dystonia or be be a greater frequency of pain, and there a part of generalized dystonia. may be additional symptoms beyond those affecting the hand.

© Dystonia Medical Research Foundation 2017 Are There Different Forms or Varieties? What Treatments are Available? How is This Likely to Change How Do I Find the Best Doctor? Some cases of hand dystonia are task-specific , No single strategy is appropriate for every or Progress Over Time? The kind of physician who is typically meaning that the dystonic symptoms occur case of hand dystonia. One of the most Hand dystonia typically begins subtly and qualified to treat hand dystonia is a only in the context of a specific activity such effective methods is to adapt tasks to diminish slowly, with gradual progression. Symptoms neurologist who specializes in movement as writing or playing a musical instrument. or avoid triggering the dystonic movements. then plateau and remain relatively stable. disorders. Occupational therapy with a When the hand is not being used for that This may involve occupational therapy or A little less than half of individuals with professional who understands dystonia particular task, the symptoms are not apparent. using assistive/adapted devices. hand dystonia develop a tremor. When hand can be extremely helpful. dystonia develops in children, the possibility For example, common manifestations of A multitude of drugs has been studied to deter - exists that it marks the beginning of early writer’s cramp include excessive gripping of a mine benefit for people with writer’s cramp, onset generalized dystonia. Isolated hand What Support is Available? pen, flexion or extension of the wrist, elevation but none appear to be uniformly effective. dystonia in adults typically begins between The Dystonia Medical Research Foundation of the elbow, and occasional extension of a About 5% of people’s symptoms improve with the ages of 30 and 50 years old and affects (www.dystonia-foundation.org) can provide finger or fingers causing the pen to fall from the use of anticholinergic drugs, such as Artane ® both men and women. educational resources, self-help opportuni - the hand while writing. Sometimes the disorder (trihexyphenidyl) and Cogentin ® (benztropine). ties, contact with others living with hand progresses to include the elevation of shoulders How is This Going to Affect dystonia, volunteer opportunities, and or the retraction of the arm while writing. Botulinum neurotoxin injections into selected My Daily Life? connection to the greater dystonia muscles may be helpful. The injections are Living well with hand dystonia is possible. community. Some cases of hand dystonia cause a sustained often given with electromyography (EMG) The early stages of onset, diagnosis, and posture of the hand such as a bend in the or ultrasound guidance, and must be repeated seeking effective treatment are often the most wrist, a clenched fist, and/or contractions in every three to six months. challenging. The symptoms may vary from What is the DMRF? the fingers. mild to severe, and fluctuate from day to day. The Dystonia Medical Research Foundation Although a medication with the word “toxin” Individuals may have to learn new ways to (DMRF) is a 501(c)3 non-profit organization Pain is typically more frequent in hand in the name may seem confusing, botulinum accomplish daily tasks, particularly those that has served the dystonia community dystonia acquired from secondary causes. neurotoxin injections have decades of research using fine motor movements. since 1976. The DMRF funds medical Isolated hand dystonia may include mild and clinical experience demonstrating that research toward a cure, promotes awareness discomfort (cramping, aching) in the fingers, they are a safe and effective medical therapy. Individuals living with dystonia are strongly and education, and supports the well being wrist, or forearm, especially while performing encouraged to: of affected individuals and families. a specific task. Treatment with botulinum neurotoxin may • Seek out the best medical care. cause muscle weakness, causing limitations • Educate yourself about dystonia and The DMRF can put you in touch with in fine motor control. Although this treatment treatment options. others with dystonia for networking and is not effective for all people, significant • Develop a multi-layered support system support. improvement of dystonic posture and reduction of support groups, online resources, friends, of pain have been reported in up to two-thirds family, and mental health professionals, of those persons treated. if needed. • Investigate complementary therapies. • Get active within the dystonia community.