title: A Clinical Profile of 125 Patients with Writer's Cramp.
abstract: BACKGROUND
  The characteristics of writer's cramp (WC) may vary according to native languages and scripts. We report the clinical profile of a large cohort of patients with WC from India.
  
  
  METHODS
  A chart review of 125 patients (F:M = 16:109) with WC seen over 10 years at the National Institute of Mental Health and Neurosciences (NIMHANS), India.
  
  
  RESULTS
  The mean age of patients was 36.8 ± 14.3, the mean age at onset (AAO) of symptoms was 31.5 ± 2.7 and the mean duration of difficulty in writing was 5.3 ± 6.3. The most common presenting complaint while writing was pain in the forearm (56%), followed by tremulousness of hand (28.8%) and abnormal posturing of hand (15.2%). Along with writing difficulty, 5.6% had difficulty in typing. The mean AAO of writing difficulty was significantly earlier in women than in men (22.8 ± 3.5 vs. 32.8 ± 4.2 years, p < 0.001). While writing, excessive extension (41.6%) of wrist was the most common abnormality, followed by excessive flexion (37.6%) and extension (19.2%) of index finger.
  
  
  CONCLUSIONS
  Women with WC have a significantly earlier age of onset than men. Excessive extension of wrist with flexion of thumb and index finger were the most common abnormalities noted in WC.
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Ketan
authors.initials: K
authors.lastname: Jhunjhunwala
authors.forename: Abhishek
authors.initials: A
authors.lastname: Lenka
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Pal
mesh_terms: D000328:Adult; D017668:Age of Onset; D020821:Dystonic Disorders; D005260:Female; D005385:Fingers; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D014481:United States