It can cause auctioneers to lose control of their tongues, prevent pianists from playing the music they've practiced for years, and force dentists to forever leave behind the plastic chair and silver drill.

It hit Anna van Fleet of Dawson, Fayette County, gradually. She worked in front of a computer at a hardware store, and began noticing that no matter how hard she tried, she couldn't grip a pen or type on a keyboard.

Like writers, musicians and other professionals who work with their hands, van Fleet was suffering from dystonia, a brain disorder that causes abnormal activation of the muscles. Focal dystonia occurs when the spasms occur in one area of the body, other types of dystonia can affect the right or left side of the body, or several body areas. Anyone who has had really bad writer's cramp will know what people with focal dystonia experience; but for dystonia sufferers, the problem persists.

Focal dystonia is curious because it can be caused by the kind of repetitive and specific motion that people do in jobs every day, like drawing on a piece of paper or sitting a certain way in a chair. But new technologies allow sufferers to get around their dystonia, by getting electrodes implanted in their brains or by receiving injections of Botox. Now, even when their bodies are saying no to a job, people with focal dystonia are finding ways to say yes.

Unsure of what caused dystonia, doctors once thought that it was psychological and would tell patients that their illness was all in their head.

Now they think it's caused by problems in the basal ganglia, which is a region of the brain that initiates and controls movement. It might be easiest to think about dystonia by comparing your brain to a computer: if you get a virus in a certain program, say Microsoft Word, you can no longer use that program. Similarly, dystonia corrupts some functions in the brain, rendering them unusable, said Dr. Nestor Galvez, the chief of movement disorders in the Cleveland Clinic in Weston, Fla.

Doctors now suspect that some patients are genetically predisposed to dystonia. Van Fleet, for example, has family members with muscle twitches and an uncle with Parkinson's disease.

"Over the past 10 to 15 years, it has become quite clear that this is a brain disorder," Galvez said. "This has led to a better understanding of the different types of treatment."

Botox was one of the first treatments for dystonia, which led to its success as a cosmetic drug today. But even after Botox, many professionals had to give up the jobs and movements they enjoyed, and so they sought different kinds of treatment.

Take Scott Adams, for example, the creator of the Dilbert comic strip. He gradually found he could no longer draw the strip with his right hand, no matter how hard he tried. He started drawing with his left hand, but that process was slow, so he found a device manufactured by Wacom Technology that allows him to draw at a different angle.

"I was lucky," he said. "The Wacom device probably added 15 years to my career."

But not everyone with dystonia can find a special machine for their job. Few patients would probably feel at ease, for example, if a dental technician asked them to open up their mouths and said technician was saddled with some sort of newfangled contraption. In the same way, it's hard for musicians to change the way they hold their instrument, or for auctioneers to speak more slowly.

People like Anna van Fleet have tried an experimental treatment called deep brain stimulation, in which electrodes are implanted on the brain to electronically stimulate some regions. The surgery is used to treat a variety of movement disorders, including Parkinson's disease, but implanting the electrodes in the brain is risky.

Van Fleet decided to try the surgery at Allegheny General Hospital after Botox still left her with quivering in her chest and difficulty holding her head upright. She couldn't write or do much of anything with her hands.

She says her handwriting is better now, and that she's returning to performing more normal actions. She thinks that the gruesome-sounding procedure was worth it, and that most others she's talked to who want to return to their jobs or their hobbies or living a normal life agree:

"I haven't met one person who said they wouldn't do it again."