Writer s cramp

Etiology and classification. Dystonia may arise from a variety of disease processes, the majority of which involve the basal ganglia. Dystonia can be classified as a generalized or focal disorder. The most common forms of dystonia are focal in nature (e.g. spasmodic torticollis, blepharospasm, writer s cramp, etc.) and occur in adults, while many of the childhood dystonias are generalized. 

Botulinum toxin is used clinically in the treatment of blepharospasm, writer s cramp, spasticities of various origins, and rigidity due to extrapyramidal disorders. It is also used to treat gustatory sweating and cosmetically to decrease facial wrinkles. Botulinum toxin A Botox, Oculinum) injected intramuscularly produces functional denervation that lasts about 3 months. Clinical benefit is seen within 1 to 3 days. Adverse effects range from diplopia and irritation with blepharospasm to muscle weakness with dystonias. 

Botulinum toxin is the treatment of choice for focal dystonias such as torticollis and writer s cramp and for hemifacial spasm, and may complement the management of spasticity. 

Other focal dystonias (writer s cramp, occupational cramps such as musician s cramp)... 

Three patients had transient dystonic reactions while taking tiagabine 20-30 mg/day in addition to carbamazepine (18). The dystonic reactions occurred during the first few weeks of treatment. The patients each had a different type of dystonia focal limb dystonia, oromandibnlar dystonia, and writer s cramp. In each case the dystonia resolved spontaneously without withdrawal of tiagabine and without any other treatment. Although paroxysmal dystonic movements have been well described with... 

Various other focal dystonias can be treated successfully by injections of botulinum toxin in the appropriate muscles. These include writer s cramp, spasmodic laryngeal dystonia which involves the vocal cords and is manifested as a strangled voice and... 

B. A (Botox , Dysport ) has an Mr of ca. 90(XX) and is used in extremely small doses in ophthalmology to treat idiopathic blepharospasm (squinting) and other spasms such as hemifacial spasm, facial paralysis, TMJ (temporomandibular joint disorder), writer s cramp, extreme sweating, etc.. Recent clinical data show, that B. is effective in the treatment of essential hand tremor and upper limb spasticity after a stroke, as well as in certain cases of headache/migraine. lit J. Neurology, Neurosurgery and Psychiatry 64, 751 (1998). 

An early form of OOS in people employed as scribes in the nineteenth century was writer s cramp . A number of musculoskeletal disorders of the upper limbs (arms) have well-known soinces related to tool design, wrist posture, or task design, and the solutions are known. 

Keywords— handwriting, ergonomics, movement analysis, computerized evaluation, writer s cramp. 

Valls-Sol6 and Hallett (1995) also presented evidence for an impaired integration of sensory inputs into the voluntary motor activity during performance of a force-related task in patients with writer s cramp. Normal (control) subjects and patients activated wrist flexor and extensor muscles to maintain a predetermined level of force rather than relying mainly on wrist flexor. These results are compatible with our findings in the effects of wrist angle on the perceived muscle soreness. 

Valls-Sol6 J., Hallett M. (1995) Modulation of electromyographic activity of wrist flexor and extensor muscles in patients with writer s cramp. Mov Disord, 10, 741-8. 

WRULD covers a number of conditions variously known as telegraphist s, writer s or twister s cramp and tenosynovitis, all of which became prescribed diseases in 1948. Other common conditions include carpal turmel syndrome, tennis and golfer s elbow. 

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