“Gol-Gappa” Dystonia – A Novel Form of Focal Task-Specific Dystonia

Background: Task-specific dystonias (TSDs) are focal movement disorders triggered by highly repetitive, skilled motor tasks, often within profession-specific contexts. Although upper limb TSDs are well documented, culturally unique forms continue to emerge.

Case Report: We present a case of a 30-year-old right-handed male who developed focal dystonia exclusively while preparing Gol-gappa (paani puri), an Indian street food requiring repetitive, precise hand movements to fill puris with spiced stuffing. Neurological examination and neuroimaging were unremarkable. Electromyography guided botulinum toxin injections into affected forearm and hand flexors resulted in approximately 70% improvement in task performance within two weeks.

Discussion: Gol-gappa dystonia represents a novel, culturally specific variant of occupational TSD. This case broadens the recognized spectrum of task-specific dystonias and supports the role of targeted botulinum therapy as an effective intervention.