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"Spooning": A Subtle Sign of Limb Dystonia
Christine Y Kim1,2, Elan D Louis1,2,3
1Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
Background:
The diagnosis of dystonia can be clinically challenging due to its heterogeneous presentation; essential tremor (ET) is a more common neurological disorder, but may be mimicked by other movement disorders, including dystonia, leading to misdiagnosis.
Phenomenology Shown:
In three patients with hand tremor, two with prior diagnoses of ET, we present examples of "spooning" of the hands, characterized by wrist flexion and metacarpophalangeal hyperextension.
Educational Value:
Subtle dystonic features such as "spooning" may be present during the evaluation of patients with tremor and aid in the diagnosis of dystonia.