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Focal task-specific dystonia (FTSD) is a disorder of skill that affects highly practiced, repetitive movements. Brain mapping and physiologic studies have revealed distorted cortical sensory maps, regional abnormalities in gray matter, increased cortical excitability, abnormalities in movement preparation, and abnormal muscle-spindle function (Adv Neurol 2004; 94:231). Although FTSD is typically unilateral, physiologic abnormalities in the brain are often bilateral, suggesting that only certain individuals with preexisting differences in brain physiology develop FTSD after the acquisition of fine motor skills. Recent studies suggest that this predisposition may be partly hereditary (Neurology 2006; 67:691).
Simple, complex, and progressive f…