AUTHOR=Datta Abhigyan , Batra Nitya , Pandey Sanjay 

TITLE=Tremor in Writer’s Cramp Patients: A Retrospective Study

JOURNAL=Dystonia

VOLUME=Volume 1 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/dystonia/articles/10.3389/dyst.2022.10075

DOI=10.3389/dyst.2022.10075

ISSN=2813-2106

ABSTRACT=Background: Tremor is one of the important motor phenotypes of dystonia, however, there is a lacuna in the literature regarding the occurrence of tremor in task-specific dystonia such as writer’s cramp (WC).  
Aims: To delineate the demographic and clinical characteristics of tremor in WC patients.
Methods: This is a detailed chart review of 105 patients of WC who were classified as WC with dystonic action tremor (WCT+) (n=39; 37.1%) and WC without tremor (WCT-) (n=66; 53.9%). 
Results: The mean age of patients was 41.10 ± 14.02 years in the WCT+ group and 36.40±14.66 years in the WCT- group. Males were more commonly affected (94.9% in WCT+ and 84.8% in WCT-). The mean duration of disease was significantly higher in WCT+ as compared to WCT- (4.16±4.48 years vs 2.57±2.81 years, p = 0.024). One-third of our patients (29.52%; n=31) were students, and the majority of them were classified as WCT- (80.64%, n=25, p=0.01). However, tremor was present in all the three doctors in our cohort with WC (p=0.03). The motor overflow to the elbow and shoulder was significantly associated with the presence of tremor (46.1% of WCT+ vs 15.2% of WCT- patients, p= 0.001). Statistically, there were no significant differences between WCT+ and WCT- patients regarding the presence of complex WC (dystonia during other activities as well) (p=0.976), mirror dystonia (p=0.211), and finger flexion/extension abnormalities (p=0.111). 
Conclusion: The presence of tremor in WC was associated with a longer duration of disease and the presence of motor overflow.