Drummers’ Dystonia

Several reviews involving large numbers of instrumental musicians with focal dystonia from centers in the United States and Europe are available in the performing arts medicine literature, but only a relatively few percussionists have been included. This article describes 6 percussion instrumentalists, out of a total of 139 musicians with dystonia, seen in the Cleveland Clinic Medical Center for Performing Artists. The five men and one woman ranged in age from 21 to 51 years at the onset of dystonia; four were playing professionally, and two were students. Duration of symptoms at the time of evaluation ranged from 1 to 10 years, although five of six were seen 3 years or less after onset. Three were primarily classical percussionists, two played mainly jazz or rock, and one played country music. Two of the six were left-handed; dystonia affected the right arm in three, the left in two, and the left more than the right in one. The nondominant limb was affected solely or predominantly in five of six. Dystonia affected primarily the forearm and wrist, rather than the digits, in contrast to most keyboard, string, and woodwind instrumentalists, presumably reflecting the relative stresses of repetitive movements in this group. A variety of treatment modalities were used before and after evaluation. Of the three musicians still actively playing, one uses anticholinergic medication before each performance, one has restricted her playing to mallet instruments, and one has had a favorable response to limb immobilization. Two others remain in music, teaching or conducting; one has been lost to follow-up.