Focal Task-specific Dystonia—From Early Descriptions to a New, Modern Formulation

BACKGROUND Vivid descriptions of the phenomenology of focal task-specific dystonia (FTSD) date back to the late nineteenth century. METHODS In this review, I summarize the natural history, phenomenology, and treatment of FTSD, focusing on nineteenth-century neurologists' descriptions of the phenomenology, etiology, treatment, and mechanism. RESULTS Examining these texts through a twenty-first-century lens, the "modern" ideas of a dystonic endophenotype, disordered physiology, and dystonic metabolic networks actually appeared in these texts more than a century ago. DISCUSSION By incorporating these ideas with recent investigations, I present a new conceptual model for understanding this mysterious malady.