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NEUROLOGY 1982;32:203
© 1982 American Academy of Neurology

Primary writing tremor

A selective action tremor

Harold L. Klawans, M.D., Russell Glantz, M.D., Caroline M. Tanner, M.D. and Christopher G. Goetz, M.D.

Department of Neurological Sciences. Rush-Presbyterian-St. Lukes Medical Center, Chicago, IL.

Progressive difficulty in handwriting due to jerking movements precipitated by the act of writing beginning between the ages of 8 to 54 is reported in six patients. There was no rest tremor, but three had mild postural tremor. Specific muscle activity (especially pronation of the wrist or abduction of the fingers) elicited the tremors that persisted as long as the evocative posture or muscle activity was maintained. None had a family history of tremors, but two had a history suggestive of hypoxia at birth. Unlike benign essential tremor, the movements did not respond to propanolol HC1, but most patients were benefited both acutely and chronically by centrally active anticholinergic agents.

Address correspondence and reprint requests to Dr. Klawans, Department of Neurological Sciences, Rush-Presbyterian-St. Lukes Medical Center. 1725 W. Harrison St., Chicago, IL 60612.

This work was supported in part by grants from the United Parkinson Foundation and the Boothroyd Foundation, Chicago, IL. Dr. Goetz is the recipient of a NINCDS Teacher-Investigator Award.

Presented in part at the thirty-second annual meeting of the American Academy of Neurology, Toronto. May, 1981.

Accepted for publication August 4, 1981.






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