A writing device improves writing in primary writing tremor

Espay, Alberto J.; Hung, Stephen; Sanger, Terence D.; Moro, Elena; Fox, Susan H.; Lang, Anthony E.

doi:10.1212/01.wnl.0000160390.25028.c3

Cited by 35 publications

(15 citation statements)

References 10 publications

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“…Recently, a writing device used successfully for writer's cramp was proven to have benefits for patients with PWT. 3 However, because treatment with standard anti-ET medication (ie, primidone or beta blockers) was never tried, no definite conclusions on the pharmacological differences and similarities of PWT and ET can be drawn from the present study.…”

Section: Discussionmentioning

confidence: 80%

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Treatment of Primary Writing Tremor With Botulinum Toxin Type A Injections

Papapetropoulos

Singer

2006

Clinical Neuropharmacology

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Primary writing tremor is a rare motor disorder in which tremor occurs primarily during writing and is not accompanied by other neurological symptoms and/or signs. Its etiopathogenesis is unknown, and treatment approaches remain largely empirical. Based on the effectiveness of botulinum toxin injections in writing dysfunction, we effectively used botulinum toxin type A for the treatment of primary writing tremor in a series of patients seen over a period of 5 years. Of the 5 patients, four received injections and reported significant and sustained treatment benefit for a period of at least 1 year. One patient declined botulinum toxin injections and responded moderately when treated with trihexyphenidyl.

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Section: Discussionmentioning

confidence: 80%

“…1,2 There is an ongoing debate about the etiology and treatment of PWT, with some reports suggesting that it may be more closely related to focal dystonia and others to essential tremor (ET). 3 In this report, we present our experience with botulinum toxin type A injections in the treatment of PWT in a series of 5 patients and discuss our results.…”

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confidence: 97%

Treatment of Primary Writing Tremor With Botulinum Toxin Type A Injections

Papapetropoulos

Singer

2006

Clinical Neuropharmacology

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“…Whether it is as form of ET or dystonia or possibly a separate disorder is unclear. Some authors have reported PWT to be responsive to propranolol, primidone and alcohol, suggesting that the disorder may be more likely a variant of ET (2,5,6,(8)(9)(10). Conversely, other investigators have described patients responsive to botulinum toxin type A (BoNT-A) and anticholinergic medications and have suggested that PWT may be a form of dystonia (14,18,19).…”

Section: Discussionmentioning

confidence: 99%

“…However, patients with tremor, such as Parkinson's tremor, can also be responsive to BoNT-A, as well as anticholinergic agents. Writing devices have also been used in patients for whom oral medications have been ineffective and with encouraging results (8). Primary writing tremor can sometimes be mistaken as writer's cramp, though the latter is generally felt to be a separate entity from PWT (2,9,12).…”

Section: Discussionmentioning

confidence: 99%

Primary writing tremor responds to unilateral thalamic deep brain stimulation

Lyons

Shneyder²,

Evidente³

2011

Turkish Neurosurgery

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Primary writing tremor is a task associated tremor which occurs during and interferes with handwriting. Considered in most cases to be a nonprogressive disorder, a number of patients are significantly debilitated by the disease. The pathophysiology of the disorder is not fully understood, but felt to represent a variant of either essential tremor or dystonia versus a separate entity. Treatment has been limited to medications, writing devices and botulinum toxin type A for most patients. Recently, deep brain stimulation has been reported in a few patients as an effective option for those patients with medically refractory symptoms. We report our experience in a patient with primary writing tremor who underwent successful thalamic deep brain stimulation, discuss the current theories on the pathophysiology of the disorder and review the current literature of deep brain stimulation for refractory primary writing tremor. KeywOrds: Primary writing tremor, Deep brain stimulation, Thalamus ÖZPrimer yazma tremoru elle yazma sırasında oluşan ve bu işlemi olumsuz etkileyen, işlemle ilişkili bir tremordur. Çoğu vakada nonprogresif bir bozukluk olduğu düşünülmektedir ama bazı hastalar bu hastalık nedeniyle ciddi maluliyet durumu yaşar. Bozukluğun patofizyolojisi tam olarak anlaşılmamaktadır, ama ayrı bir antite yerine esansiyel tremor veya distoninin bir varyantı olduğu düşünülmektedir. Tedavi çoğu hastada ilaçlar, yazmaya yardımcı cihazlar ve botulinum toksini tip A ile sınırlıdır. Son zamanlarda derin beyin stimülasyonu tıbben refrakter belirtileri olan bazı hastalarda etkili bir seçenek olarak bildirilmiştir. Başarılı talamik derin beyin stimülasyonu yapılan bir primer yazma tremorlu hastayla deneyimimizi bildiriyor, bozukluğun patofizyolojisiyle ilgili mevcut teorileri açıklıyor ve refrakter primer yazma tremoru için derin beyin stimülasyonuyla ilgili güncel literatürü gözden geçiriyoruz.AnAhtAr sÖZCÜKler: Primer yazma tremoru, Derin beyin stimülasyonu, Talamus

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“…Briefly, different approaches have been studied, including the use of Treatment of Tremor tremor-suppressing orthoses 129,130 (eg, externally applied devices, to suppress tremor using viscous materials, weighted splints, and vibration therapies). Physical therapy interventions include strength training, 131,132 resistance training, 133 or massage.…”

Section: Nonpharmacologic Treatment Optionsmentioning

confidence: 99%