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Unusual delayed and prolonged arm weakness and atrophy following botulinum toxin injection for musician's cramp: case report.

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Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.

Botulinum toxin is considered first-line treatment for focal hand dystonia in musicians. Mild, temporary weakness is a common accompaniment of effective injection. We present a unique case of delayed-onset, severe, prolonged weakness and atrophy in a patient with musician's dystonia, successfully treated with botulinum toxin for over 10 years, following injection of his usual muscles at his well-established dose.

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