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.