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Tremor Other Hyperkinet Mov (N Y). 2018 Dec 3;8:607. doi: 10.7916/D8B00NRV. eCollection 2018.

"Spooning": A Subtle Sign of Limb Dystonia.

Kim CY1,2, Louis ED1,2,3.

Author information

1
Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
2
Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
3
Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.

Abstract

Background:

The diagnosis of dystonia can be clinically challenging due to its heterogeneous presentation; essential tremor (ET) is a more common neurological disorder, but may be mimicked by other movement disorders, including dystonia, leading to misdiagnosis.

Phenomenology Shown:

In three patients with hand tremor, two with prior diagnoses of ET, we present examples of "spooning" of the hands, characterized by wrist flexion and metacarpophalangeal hyperextension.

Educational value:

Subtle dystonic features such as "spooning" may be present during the evaluation of patients with tremor and aid in the diagnosis of dystonia.

KEYWORDS:

Dystonia; essential tremor

Conflict of interest statement

Funding: None. Conflicts of Interest: The authors report no conflict of interest. Ethics Statement: All patients that appear on video have provided written informed consent; authorization for the videotaping and for publication of the videotape was provided.

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