A 37-year-old software engineer who was passionate about playing the guitar started to feel weird when the three fingers of his left hand, which are very important to play the instrument, suddenly stopped listening to him. and he was not able to play the guitar anymore.
Being a techie by profession, he could not even use those fingers and type anything.
However, if he had to button or unbutton his shirt or do any other activity, he would be able to use the same three fingers with ease.
Abhishek, after visiting several doctors, and undergoing a series of tests, was finally diagnosed with a rare condition known as “guitar cramps” or “guitarist dystonia”.
This subset of dystonia — a movement disorder that causes the muscles to involuntarily contract — is called focal hand dystonia or task-specific focal hand dystonia.
Abhishek underwent surgery in 2017 and subsequent rehabilitation programmes, and on Sunday, 22 January, played his self-composed music on the guitar at the Punarpraapti 2023, an event held in NIMHANS Bengaluru to showcase the future of functional neurosciences.
What is dystonia?
Explaining the condition, Hyderaabad-based Apollo Hospital neurologist Dr Sudhir Kumar told South First that dystonia is a condition that causes unusual movements.
“While the exact reason for this condition is not known, it is believed to be an abnormality in the chemicals in the brain. To perform any movements, there should be signals given from the brain. Some improper signalling from the brain areas leads to dystonia,” he said.
Kumar added that there are other names for focal dystonia, like focal task-specific dystonia, focal hand dystonia, and even ocupational cramp or dystonia (for bankers in general and cashiers in particular, and for writers, where it is known as writer’s cramp).
Some of them even have dystonia when playing the violin or mouth organs.
Explaining further, Brain and Spine Intervention Centre Consultant Neurosurgeon Dr HV Satish Babu said that dystonia involving a focal area happens when the brain sends too many commands to the muscles. This causes spasms in the muscles.
“Music dystonia occurs in musicians who play instruments requiring extremely fine motor skills,” he explained.
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What is a guitar cramp?
Abhishek, a native of Bihar working in Bengaluru, who wanted to be a guitarist.
However, he started to see his dream crumble when he suddenly could not move his three fingers in 2017.
Abhishek approached several doctors, but they could not diagnose his problem.
However, an orthopaedic doctor from Manipal Hospitals referred him to a neurologist at Mahaveer Jain Hospitals in Bengaluru, Dr Sharan Srinivasan.
The latter, after understanding the patient’s condition, performed surgery on Abhishek.
Srinivasan explained to South First: “What’s interesting in the task-specific dystonia is that there is no paralysis; the fingers are fine. If he pretends to play the guitar without the guitar, he can play it without any hassle. The moment you put the guitar in his hand, he goes to play and he cracks,”
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The reason here is that the circuit in the brain is misbehaving, explained the doctor.
The patient has to be awake during the Deep Brain Stimulation surgery, so Abhishek had to play the guitar during the procedure.
Here, electrodes are implanted into the part of the brain that controls the affected muscles.
The doctor has to then find the right circuit and burn it to help the patient so that the cramp goes away.
Kumar said that this condition was not very common and it could occur in any age group. However, it was more often seen in people aged 20-50 years and affected both genders equally.
What are the diagnosis and treatment options?
While Abhishek had to undergo Deep Brain Stimulation surgery, doctors say that surgery is not always required.
Srinivasan explained that if the patient is in the early stages, then they respond well to medication.
Another treatment is botox, where the botulinum neurotoxin — one of the most poisonous biological substances known to the human race — is injected into the affected part, and this procedure seems to have elicited some good response.
However, in the advanced stages, the condition requires deep brain stimulation surgery and the recovery after DBS is qualitative, explained the doctor.