Musician's Dystonia clinical trials

Comparison of Electrophysiologic and Ultrasound Guidance for Onabotulinum Toxin A Injections in Focal Upper Extremity Dystonia and Spasticity

Background: - It is hard for people with arm spasticity and focal hand dystonia to control their arm and hand muscles. They are often treated with botulinum toxin (BoNT) injections. Electromyography with electrical stimulation (e-stim) and ultrasound are used to find muscles for BoNT injection. Researchers want to learn which method is faster and more comfortable. Objective: - To compare 2 ways of finding muscles for BoNT injection for the treatment of focal hand dystonia and upper limb spasticity. Eligibility: - Adults 18 and older with focal hand dystonia or arm spasticity who have been getting onabotulinumtoxin-A injections in protocol 85-N-0195. Design: - Participants will be screened with medical history and physical exam. - Participants will push or pull on a device that measures arm strength. They will have a neurologic exam. Women will have a pregnancy test. - Participants will have a BoNT injection using either e-stim or ultrasound. - For e-stim, sticky pads will be placed on the arm. A needle will be placed in the muscle. A small electric shock will be given through the needle. Then the injection will be given. - For ultrasound, a probe will be moved across the skin. A screen will show an image of the muscles. Then the injection will be given. - Participants will have a second injection 3 months later. They will have the method that was not used for their first injection. - After each session, participants will rate their experience. - Participants will have follow-up visits 1 month after each injection. They will be examined and asked about their response to treatment. Arm strength will be measured.