ABSTRACT
CASE PRESENTATION A 56-year-old professional guitarist presented for evaluation of a progressive decline in his ability to play. Nine years previously he had noticed a decrease in the speed of his dominant right hand while playing, and over time his ability had gradually declined, especially during the year before being seen. Classical playing, requiring all five fingers to strum, was described as ‘90 % off’, whereas jazz pieces were only ‘2 % off’ as they were done with a pick. While playing classical music, digits 3, 4, and 5 would flex involuntarily. When he attempted to increase his finger speed, the fingers would ‘lock’. He tended to miss notes. The involuntary movements also interfered with demonstrations to his students. About 4 years after the onset of difficulty playing guitar, he noticed a similar decline in his handwriting, but all other tasks were performed normally. There was no family history of a movement disorder.
