title: Bilateral Stereotactic Thalamotomy for Bilateral Musician's Hand Dystonia.
abstract: BACKGROUND
  Focal hand dystonia in musicians, also known as musician's dystonia, is a task-specific movement disorder characterized by unwanted involuntary muscle contractions occurring only when playing a musical instrument.
  
  
  METHODS
  Case 1 was a 50-year-old female professional pianist who underwent staged bilateral ventro-oral (Vo) thalamotomy, with an interval between the first and second surgery of 4 years. The first surgery (right Vo thalamotomy) led to significant improvements in dystonic symptoms without any complications. Pre- and postoperative Tubiana's musician's dystonia scale (TMDS) scores were 2 and 5, respectively. The second surgery (left Vo thalamotomy) also led to significant improvements in dystonic symptoms, with dysarthria and verbal recall disturbance resolving within 3 months. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to live-stage performances. Case 2 was a 48-year-old male clarinet repair technician who underwent staged bilateral Vo thalamotomy, with an interval between the first and second surgery of 13 months. The first surgery (right Vo thalamotomy) led to dramatic improvements in symptoms without any complications. Pre- and postoperative TMDS scores were 2 and 5, respectively. The second surgery (left Vo thalamotomy) also led to significant improvements in symptoms with transient hypophonia. Pre- and postoperative TMDS scores were 2 and 5, respectively. The patient was subsequently able to return to work without difficulty.
  
  
  CONCLUSIONS
  The findings in these 2 cases indicate the utility of bilateral stereotactic Vo thalamotomy in the treatment of medically intractable musician's dystonia affecting both hands.
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Horisawa
authors.affiliation: Department of Neurosurgery, Kumamoto Takumadai Rehabilitation Hospital, Kumamoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Goto
authors.affiliation: Department of Neurosurgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.affiliation: Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan. Electronic address: ttaira@nij.twmu.ac.jp.
authors.forename: Takaomi
authors.initials: T
authors.lastname: Taira
mesh_terms: D020821:Dystonic Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009146:Music; D013238:Stereotaxic Techniques; D013788:Thalamus / Q000502:physiology* / Q000601:surgery; D016896:Treatment Outcome
keywords: Focal hand dystonia; Musician's dystonia; Thalamotomy