Dr. Giuris--Piano Case

I do treatment with Botulinum Toxin for dystonia and spasticity and I feel
reasonably confident but: I saw a professional pianist, who has dystonia of
his right hand. He is so incapacitated, he cannot give a concert. He can
still manage to play for himself, but with great difficulty. The fingers III
and IV curl involuntarily. I am going to observe him play the piano at home
and I will try to help him with BTX injections. If I fail, I would like to
be able to recommend somebody who has experience with Botulinum Toxin
treatment of musicians. Could you recommend such a colleague, if possible in
Thank you.


Emanuil Giuris, M.D.
Thessaloniki, Greece

Dear Listmembers,
after I asked the patient for permission, I posted a 1.6 MB (1670 KB) video
file onto my website. You can see the pianist playing with
1. the healthy L hand filmed from the left, from above and from the right
2. the dystonic R hand filmed from the left, from above and from the right.
He complained that he could not control sufficiently his 3rd and 4rth
fingers. I saw flexion of the 3rd finger at the metacarpoph joint and
extension at the interph joints. I saw curling of the 4th and 5th fingers.
What do you see/think? I would be grateful for suggestions.
You can download the file by clicking on this:

Emanuil Giuris
Thessaloniki, Greece


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September 29, 2004

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