Background: Hairdresser's dystonia is a rarely reported form of focal hand dystonia, and the clinical course and treatment remains poorly understood. Objectives: The aim of this report was to clarify the impact of thalamotomy on hairdresser's dystonia. Methods: Four consecutive patients with hairdresser's task-specific dystonia evaluated at Tokyo Women's Medical University Hospital between 2008 and 2013 were treated with stereotactic thalamotomy, and were recruited for this case series. Results: The mean age at the onset of symptoms was 37.25 ± 10.64 years, the median duration of symptoms was 4.25 ± 1.3 years, and the mean follow-up period was 17 ± 12.37 months. Two of the 4 patients returned to work with significant improvement following the stereotactic thalamotomy and the beneficial effects persisted for the duration of their clinical follow-up. The other 2 patients experienced transient improvements for up to 3 months. Surgical complications included only dysarthria in 2 patients, and did not interfere with their daily activities. No patients experienced a deterioration of dystonic symptoms after thalamotomy. Conclusion: Although the benefits of thalamotomy remain vulnerable to incorrect or insufficient coagulation, stereotactic thalamotomy may be a feasible and effective procedure for patients with hairdresser's dystonia.

Keywords:
Focal hand dystonia, Hairdresser’s dystonia, Thalamotomy
1.
Marsden CD, Sheehy MP: Writer's cramp. Trends Neurosci 1990;13:148-153.
2.
Tubiana R: Musician's focal dystonia. Hand Clin 2003;19:303-308.
3.
Jankovic J, Ashoori A: Movement disorders in musicians. Mov Disord 2008;23:1957-1965.
4.
Altenmuller E, Jabusch HC: Focal dystonia in musicians: phenomenology, pathophysiology, triggering factors, and treatment. Med Probl Perform Art 2010;25:3-9.
5.
Aranguiz R, Chana-Cuevas P, Alburquerque D, Leon M: Focal dystonia in musicians. Neurologia (Barcelona, Spain) 2011;26:45-52.
6.
Schuele S, Lederman RJ: Long-term outcome of focal dystonia in string instrumentalists. Mov Disord 2004;19:43-48.
7.
Siegfried J, Crowell R, Perret E: Cure of tremulous writer's cramp by stereotaxic thalamotomy: case report. J Neurosurg 1969;30:182-185.
8.
Goto S, Tsuiki H, Soyama N, Okamura A, Yamada K, Yoshikawa M, Hashimoto Y, Ushio Y: Stereotactic selective Vo-complex thalamotomy in a patient with dystonic writer's cramp. Neurology 1997;49:1173-1174.
9.
Taira T, Hori T: Stereotactic ventrooralis thalamotomy for task-specific focal hand dystonia (writer's cramp). Stereot Funct Neurosurg 2003;80:88-91.
10.
Shibata T, Hirashima Y, Ikeda H, Asahi T, Hayashi N, Endo S: Stereotactic Voa-Vop complex thalamotomy for writer's cramp. Eur Neurol 2005;53:38-39.
11.
Horisawa S, Taira T, Goto S, Ochiai T, Nakajima T: Long-term improvement of musician's dystonia after stereotactic ventro-oral thalamotomy. Ann Neurol 2013;74:648-654.
12.
Asahi T, Koh M, Kashiwazaki D, Kuroda S: Stereotactic neurosurgery for writer's cramp: report of two cases with an overview of the literature. Stereot Funct Neurosurg 2014;92:405-411.
13.
Roberts K, Mahon B, O'Rourke K, Lynch T: ‘Club-cutting' dystonic tremor: a case report. Tremor Other Hyperkinet Mov (NY) 2013, DOI: 10.7916/D85X27N2.
14.
Giorelli M, Zimatore GB: Hairdresser's dystonia: an unusual occupational dystonia. Tremor Other Hyperkinet Mov (NY) 2013, DOI: 10.7916/D87S7MGH.
15.
Hallett M, Benecke R, Blitzer A, Comella CL: Treatment of focal dystonias with botulinum neurotoxin. Toxicon 2009;54:628-633.
16.
Schuele S, Jabusch HC, Lederman RJ, Altenmuller E: Botulinum toxin injections in the treatment of musician's dystonia. Neurology 2005;64:341-343.
17.
Lenz FA, Jaeger CJ, Seike MS, Lin YC, Reich SG, DeLong MR, Vitek JL: Thalamic single neuron activity in patients with dystonia: dystonia-related activity and somatic sensory reorganization. J Neurophysiol 1999;82:2372-2392.
18.
Zhuang P, Li Y, Hallett M: Neuronal activity in the basal ganglia and thalamus in patients with dystonia. Clin Neurophysiol 2004;115:2542-2557.
19.
Chen RS, Tsai CH, Lu CS: Reciprocal inhibition in writer's cramp. Mov Disord 1995;10:556-561.
20.
Rosenkranz K, Altenmuller E, Siggelkow S, Dengler R: Alteration of sensorimotor integration in musician's cramp: impaired focusing of proprioception. Clin Neurophysiol 2000;111:2040-2045.
21.
Fox MW, Ahlskog JE, Kelly PJ: Stereotactic ventrolateralis thalamotomy for medically refractory tremor in post-levodopa era Parkinson's disease patients. J Neurosurg 1991;75:723-730.
22.
Tomlinson FH, Jack CR Jr, Kelly PJ: Sequential magnetic resonance imaging following stereotactic radiofrequency ventralis lateralis thalamotomy. J Neurosurg 1991;74:579-584.
23.
Fukaya C, Katayama Y, Kano T, Nagaoka T, Kobayashi K, Oshima H, Yamamoto T: Thalamic deep brain stimulation for writer's cramp. J Neurosurg 2007;107:977-982.
24.
Doshi PK: Long-term surgical and hardware-related complications of deep brain stimulation. Stereotact Funct Neurosurg 2011;89:89-95.
25.
Baizabal Carvallo JF, Mostile G, Almaguer M, Davidson A, Simpson R, Jankovic J: Deep brain stimulation hardware complications in patients with movement disorders: risk factors and clinical correlations. Stereotact Funct Neurosurg 2012;90:300-306.
26.
Fenoy AJ, Simpson RK Jr: Risks of common complications in deep brain stimulation surgery: management and avoidance. J Neurosurg 2014;120:132-139.
27.
Videnovic A, Metman LV: Deep brain stimulation for Parkinson's disease: prevalence of adverse events and need for standardized reporting. Mov Disord 2008;23:343-349.
28.
Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, Frysinger RC, Sperling SA, Wylie S, Monteith SJ, Druzgal J, Shah BB, Harrison M, Wintermark M: A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2013;369:640-648.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.