This disabling movement disorder affects the person’s professional task, whether be it a writing - as seen here, or playing music……… this too can be cured!!
Dystonia is an involuntary, sustained muscle contraction with abnormal posturing. Focal dystonia affects a part of the body. Writer’s cramp is a type of focal dystonia of the fingers, hand and/or forearm, it is specific to the task of writing, thus the name, and is the most common focal primary dystonic disorder.
It typically begins with an abnormally tight grip when a person writes and gradually progresses, making simple tasks such as holding a pen and writing very difficult.
Though initially thought to be associated with only writing later on it has been found that it is also associated with any particular task that a person performs repeatedly.
This could be a musician playing a musical instrument, Asst Surgeon performing surgery and his dystonia would occur when he holds the scalp, or a barber or a hairdresser while dressing of the head, etc.
Writer’s cramp can be primary or secondary (painful) and simple or dystonic. In some cases, patients with DYT1 dystonia (primary and generalized dystonia) can have a writer’s cramp as the only symptom. Writer’s cramp is often mistaken for over-use conditions.
Over-use syndromes or repeated-use syndromes are usually characterized by pain, whereas the writer’s cramp is more likely to cause problems with coordination and is rarely painful.
It is due to both sensory impairment with decreased spatial sensitivity and a motor abnormality. The main pathophysiology being the disorganization of the sensory-motor system due to loss of inhibition, aberrant neural plasticity, and defective learning-based sensory-motor integration.
It is most prevalent between the ages of 30 to 50 years. Males are more commonly affected than females, but the latter present earlier.
Risk factors and causes of Writer’s dystonia
Idiopathic (the majority of cases)
Increased writing time or performing any kind of repetitive hand movements
Family history (5%-20%), usually in early-onset generalized dystonia, associated with DYT1 gene
Rare causes- injury to hand or arm, C6 ruptured disc, lithium use, basal ganglia or cortical tumors, arteriovenous malformations, and stroke.
