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Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL 33136, USA. spapapetropoulos@med.miami.edu
Primary writing tremor is a rare motor disorder in which tremor occurs primarily during writing and is not accompanied by other neurological symptoms and/or signs. Its etiopathogenesis is unknown, and treatment approaches remain largely empirical. Based on the effectiveness of botulinum toxin injections in writing dysfunction, we effectively used botulinum toxin type A for the treatment of primary writing tremor in a series of patients seen over a period of 5 years. Of the 5 patients, four received injections and reported significant and sustained treatment benefit for a period of at least 1 year. One patient declined botulinum toxin injections and responded moderately when treated with trihexyphenidyl.
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