Rockstar hands: a complex pattern of hand dystonia in Wilson's disease

A 27-year-old man presented with subacute generalized dystonia, low ceruloplasmin levels, and increased copper urinary excretion which were consistent with the diagnosis of Wilson's disease (WD). Following initial treatment, the dystonia improved significantly, but hand involvement persisted ([ Figure 1 ]). Dystonia affecting the hands may present in various forms. Complex patterns previously reported include starfish hand,[ 1 ] claw hand,[ 2 ] and task-specific dystonias, comprising musician's dystonia, writer's cramp, and hairdresser's dystonia,[ 3 ] among others.[ 4 ] Dystonia in young patients warrants prompt investigation to rule out reversible conditions including WD.[ 5 ] Accurate recognition of the muscles involved in dystonia is important for optimal treatment with botulinum toxin. Figure 1 Rockstar hand refers to a specific dystonic posture in a patient diagnosed with Wilson disease. The posture of the hands resembles the finger and hand positions commonly seen in guitar players playing rock songs with major barre chords. The fingers exhibit a distinctive pattern, with the left 3 rd and 4 th flexed, while the 2 nd and 5 th digit are extended. This pattern suggests coactivation of the flexor digitorum superficialis, flexor digitorum profundus, flexor carpi ulnaris, flexor carpi radialis, extensor digitorum communis, and extensor digiti minimi. Editor-in-chief Ayrton Roberto Massaro. Associate Editor José Luiz Pedroso. Authors' Contributions LEBMZ: investigation, conceptualization, data curation, methodology, and writing – editing and review; RCA, FMBG: conceptualization, investigation, supervision, validation, visualization, writing – original draft, and writing – review & editing; HAGT: conceptualization, investigation, supervision, validation, visualization, and writing – review & editing. Publication History Received: 02 May 2024 Accepted: 21 July 2024 Article published online: 02 October 2024 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Bibliographical Record Luis Eduardo Borges de Macedo Zubko, Renata Cristine Alves, Francisco Manoel Branco Germiniani, Hélio Afonso Ghizoni Teive. Rockstar hands: a complex pattern of hand dystonia in Wilson's disease. Arq Neuropsiquiatr 2024; 82: s00441790573. DOI: 10.1055/s-0044-1790573

Abstract licence: CC BY

4 more references, whose wording the paper’s licence keeps private.

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.