Clinical Relevance of Neuromuscular Findings and Abnormal Movement Patterns: A Comparison between Focal Hand Dystonia and Upper Extremity Entrapment Neuropathies

Narrative Review

Patients with focal hand dystonia and upper extremity entrapment neuropathies may present with similar symptoms and risk factors making it difficult to distinguish between the two diagnoses. Evaluating for the presence of neuromuscular findings and abnormal movement patterns can help assist the hand therapist in identifying the presence of focal hand dystonia or peripheral motor axon involvement in the absence of pronounced muscle atrophy. The purposes of this review article are twofold. First, to describe selected neuromuscular signs and symptoms characteristic of patients presenting with repetitive overuse syndromes of the upper limb leading to either a nerve entrapment syndrome or a focal hand dystonia. The selected topics will be limited to an overview of ectopic neuronal activity with an emphasis on fasciculations, muscle spasms/cramps, and sensation (including pain). Second, the article will conclude with a brief synopsis of focal hand dystonia and compression neuropathies, highlighting general assessment and treatment principles.