A 34-year-old Japanese woman who was employed as childcare worker and who had always carried infants/toddlers with her left arm developed immobility of the left fourth and fifth fingers, which had worsened over a few months. She showed metacarpophalangeal hyperextension and proximal interphalangeal flexion (claw hand) (Picture) with distal dysesthesia on the ulnar side; however, the muscle strength of the ulnar-innervated muscles was normal. A nerve conduction study in the ulnar nerve did not show significant lesions. Pseudodystonia, which can present with a fixed dystonic posture, was excluded. The symptoms recovered over a 2-month period without treatment.
Picture.
Although this case did not have somatoform or psychogenic disorders, the following characteristics of fixed dystonia were met: the condition predominantly occurs in young women, it is associated a subacute limb onset, it is occasionally localized at the site of onset, it is associated with the absence of sensory tricks and action-specificity, and it is associated with a precipitating event (limb overuse in this case) (1). Claw hand due to fixed dystonia is rarely encountered (2).
The authors state that they have no Conflict of Interest (COI).
References
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