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A Clinical Profile of 125 Patients with Writer's Cramp
Ketan Jhunjhunwala1, Abhishek Lenka, Pramod Kumar Pal
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Background:
The characteristics of writer's cramp (WC) may vary according to native languages and scripts. We report the clinical profile of a large cohort of patients with WC from India.
Methods:
A chart review of 125 patients (F:M = 16:109) with WC seen over 10 years at the National Institute of Mental Health and Neurosciences (NIMHANS), India.
Results:
The mean age of patients was 36.8 ± 14.3, the mean age at onset (AAO) of symptoms was 31.5 ± 2.7 and the mean duration of difficulty in writing was 5.3 ± 6.3. The most common presenting complaint while writing was pain in the forearm (56%), followed by tremulousness of hand (28.8%) and abnormal posturing of hand (15.2%). Along with writing difficulty, 5.6% had difficulty in typing. The mean AAO of writing difficulty was significantly earlier in women than in men (22.8 ± 3.5 vs. 32.8 ± 4.2 years, p < 0.001). While writing, excessive extension (41.6%) of wrist was the most common abnormality, followed by excessive flexion (37.6%) and extension (19.2%) of index finger.
Conclusions:
Women with WC have a significantly earlier age of onset than men. Excessive extension of wrist with flexion of thumb and index finger were the most common abnormalities noted in WC.
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