Treatment of dystonic writers’ Cramp

Abstract

Dystonic writers’ cramp is a form of task-specific, focal dystonia. It is most commonly seen as part of an idiopathic focal, segmental or generalised isolated dystonia syndrome but can also occur as part of either isolated or combined or inherited or acquired dystonia. The treatment of choice is botulinum toxin injections, but the response rate is lower than with other forms of focal dystonia such as cervical dystonia or blepharospasm. Oral medications are usually ineffective. In botulinum toxin-resistant cases, there is some evidence to support the use of motor or sensory retraining or, in exceptional circumstances, functional neurosurgery.