Clinical parkinsonism & related disorders · 2025
Dystonic tremor in Writer's cramp Mimicking primary handwriting tremor.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cataniag Paulo, Suratos Cezar Thomas, Diesta Cid Czarina, Ong Jed Noel
Аннотация
INTRODUCTION: Writer's cramp is a task-specific focal dystonia with peculiarity of occurring only during handwriting. The presence of abnormal posturing and dystonic tremor may exhibit distinctive patterns across individuals, and may closely resemble primary writing tremor, especially when dystonic postures are mild.
CASE DESCRIPTION: We present a 48-year-old right-handed Filipino businessman who developed a gradually worsening right-hand tremor confined to handwriting over one year, stabilizing after six months. Neurological examination was otherwise normal, but writing tests revealed dystonic wrist extension and shoulder abduction, along with wrist rotational/pronation-supination dystonic tremor during writing. Wavy/oscillating drawing patterns were observed. Diagnosis of writer's cramp was made, which mimicked primary writing tremor due to overlapping features. Multiple oral medications were ineffective, but ultrasound-guided botulinum toxin injections led to clinical improvements, with better handwriting during faster writing and worse at slower speeds.
CONCLUSION: This case underscores the complexity of diagnosing and treating task-specific dystonia with tremor. Incorporating tests like line-drawing at different speeds, including vertical and diagonal lines, can enhance evaluation.
CASE DESCRIPTION: We present a 48-year-old right-handed Filipino businessman who developed a gradually worsening right-hand tremor confined to handwriting over one year, stabilizing after six months. Neurological examination was otherwise normal, but writing tests revealed dystonic wrist extension and shoulder abduction, along with wrist rotational/pronation-supination dystonic tremor during writing. Wavy/oscillating drawing patterns were observed. Diagnosis of writer's cramp was made, which mimicked primary writing tremor due to overlapping features. Multiple oral medications were ineffective, but ultrasound-guided botulinum toxin injections led to clinical improvements, with better handwriting during faster writing and worse at slower speeds.
CONCLUSION: This case underscores the complexity of diagnosing and treating task-specific dystonia with tremor. Incorporating tests like line-drawing at different speeds, including vertical and diagonal lines, can enhance evaluation.