Frederick Delius: controversies regarding his neurological disorder and its impact on his compositional output.

Frederick Delius was born in Yorkshire, England, on June 29, 1862, the son of German immigrants. He showed early musical talent but his father, a wealthy wool merchant, insisted he pursue a business career. After several failures, including an assignment managing an orange grove near Jacksonville, Florida, his father agreed to support his musical studies in Leipzig, assuming he would then become self-sufficient.

Alice G. Brandfonbrener, MD-A personal remembrance.

Alice Brandfonbrener died peacefully at home on May 31, 2014, after a protracted illness. For all of us involved in performing arts medicine, she was the inspiration and guiding spirit. She will be missed.

Presence of voltage-gated potassium channel complex antibody in a case of genetic prion disease.

Voltage-gated potassium channel (VGKC) complex antibody-mediated encephalitis is a recently recognised entity which has been reported to mimic the clinical presentation of Creutzfeldt-Jakob disease (CJD). Testing for the presence of this neuronal surface autoantibody in patients presenting with subacute encephalopathy is therefore crucial as it may both revoke the bleak diagnosis of prion disease and allow institution of potentially life-saving immunotherapy. Tempering this optimistic view is the rare instance when a positive VGKC complex antibody titre occurs in a definite case of prion disease.

Sural mononeuropathy: a report of 36 cases.

Introduction: Isolated sural mononeuropathy is rare and frequently constitutes a diagnostic challenge.

Methods: This investigation was a retrospective study of sural neuropathy at a single electrodiagnostic center.

Results: Our study included 36 patients with sural neuropathy, the largest sample so far reported.

Primary bowing tremor: a task-specific movement disorder of string instrumentalists.

Fear of a tremulous or unsteady bow is widespread among string instrumentalists. Faulty technique and performance anxiety have generally been blamed. The cases of 4 high-level violinists and 1 violist, 3 women and 2 men, with uncontrollable bow tremor are presented.

Focal peripheral neuropathies in instrumental musicians.

Instrumental musicians often seek medical consultation for symptoms suggestive of nerve entrapment. About 20% of those seen in the author's performing artists' clinic were diagnosed with a focal neuropathy. In general, neuropathies that are most common in the overall population tend also to be most common among musicians, although some expectations exist, including, for example, localized peri-oral sensory syndromes associated with playing a brass instrument, and, possibly, ulnar neuropathies related to the playing position of bowed string players.

Botulinum toxin injections in the treatment of musician's dystonia.

The authors present the results of 84 musicians with focal task-specific dystonia treated with EMG-guided botulinum toxin injections. Treatment outcome was assessed by subjective estimation of playing before and after treatment and self-rating of treatment response. Fifty-eight (69%) of the musicians experienced improvement from the injections and 30 of 84 musicians (36%) reported long-term benefit in their performance ability.

Long-term outcome of focal dystonia in string instrumentalists.

This study describes the clinical characteristics and long-term outcome in string instrumentalists with focal task-specific dystonia. We present the results of a follow-up telephone survey of 21 violin and viola players with focal dystonia. Eighteen musicians responded to the questionnaire.

Multifocal varicella-zoster virus vasculopathy without rash.

A 51-year-old woman with CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) developed stepwise progressive focal neurological deficits without zoster rash. Multifocal ischemic infarcts were seen on magnetic resonance imaging, and cerebral angiography revealed focal stenosis of arteries affecting the intracranial circulation. A brain biopsy was nondiagnostic.

Neuromuscular problems in musicians.

Background: Musicians are an occupational (or avocational) group that may on occasion have highly specific health care problems apparently caused by or adversely affecting instrumental performance. Neurologists have been intimately involved in the development of a burgeoning interest in these disorders and, because of the nature of the most common symptoms, neurologists can expect to be called upon to evaluate such patients.

Review Summary: In this review, the most common playing-related disorders are discussed.

Neuromuscular and musculoskeletal problems in instrumental musicians.

Over the past 20 years, there has been increasing interest in the medical problems of performing artists. In this review, the major playing-related disorders seen in instrumental musicians are discussed. Among the 1353 instrumentalists personally evaluated, the major diagnoses included musculoskeletal disorders in 64%, peripheral nerve problems in 20%, and focal dystonia in 8%.