writing cramps
Introduction
Writing Introduction Writingspasm, also known as primary writing tremor (primary writingtremor), is the most common action tremor in adults, especially when writing tremors, making writing the most common. The disease is more common in clinical practice, which means that the patient has 5 to 8 Hz hand tremor when writing or writing, without other dysfunction. Some patients with tremor are not completely limited to writing movements, but may also have tremors when doing other similar work or using similar tools. Therefore, it has been suggested that writing sputum can be divided into task-inducing writing and posture-sensitive writing . basic knowledge The proportion of illness: 0.0013% Susceptible people: no special people Mode of infection: non-infectious Complications: idiopathic tremor muscle spasm
Cause
Writing cause
Cause (30%):
This disease is mostly a neurological disease, and some scholars believe that the disease is an extrapyramidal disease, or is considered to be a sympathetic reflex disorder. Making writing difficult is the most common.
Pathogenesis (10%):
Hypertonic hyperthyroidism is the most common. When you write, your hand muscles and wrist muscles are paralyzed. Or you can't use pens freely because of weak muscles. It is similar to paralysis. It is also sporty and hyperactive. When you write, your hand muscles and wrist muscles tremble and gradually increase. Mental stress is more pronounced and is the result of active muscles and antagonistic muscle disorders.
Prevention
Writing plaque prevention
Those with a genetic background, carry out genetic counseling, carrier genetic testing and prenatal diagnosis and selective abortion to prevent the birth of children. Keep your mood steady and avoid emotional excitement and tension.
Complication
Writing sputum complications Complications , idiopathic tremor, muscle spasm
No special records, or may have idiopathic tremor or neurological signs.
Symptom
Writing sputum symptoms Common symptoms Computer loss of writing Hand tremor Wrist pain writing Fatigue paralysis weakness
The disease mainly occurs in people who have been writing for a long time from 20 to 50 years old, especially for writing workers. Some patients have a positive family history. Most of the onsets of the onset are slow and gradual, first feeling the fingers are prone to fatigue or wrist pain, followed by There is a special writing sputum, the patient is difficult to hold the pen or start writing. This sputum phenomenon mainly occurs in the fingers, wrists and even the entire upper limbs. The most important feature of this disease is sputum during writing, the symptoms disappear when not writing, muscle strength It is completely normal, sometimes only with a pen, small pen is difficult, completely normal with a pencil or a large pen, the patient can work normally, there is no misuse, the disease is mostly a neurological disease, but some cases can be seen at the time of examination The muscle tension between the wrist and the wrist is high, and the wrist joint is resistant to gears when it is passively rotated. Therefore, some people think that the disease is an extrapyramidal disease, and some people think it is a sympathetic reflex disorder.
In general, writing sputum can be divided into three types:
1. type (muscle tension type): It is the most common type, which quickly causes the hand muscles, wrist muscles to twitch or alternately contract.
2. Paralyzed type (inability type): The patient has fatigue and weakness when writing, because the muscles are weak and cannot be arbitrarily controlled. It is similar to the paralyzed state and cannot use the pen. Sometimes the pain occurs along the nerve.
3. Tremor type (sports hyperactivity type): Hand-shake tremor can be seen when writing, and the writing tremor is gradually enhanced, especially under the influence of mental stress, which is the result of active muscle and antagonistic muscle disorder.
Examine
Writing inspection
Laboratory examination
Blood electrolytes, drugs, trace elements and biochemical tests help to differentiate the diagnosis of this disease.
2. Other auxiliary inspections
CT and MRI examinations are meaningful for the differential diagnosis of intracranial diseases and are easier to find. Electromyography is useful for differential diagnosis. Genetic analysis is important for the identification of certain hereditary dystonia.
Diagnosis
Writing diagnosis
Diagnostic criteria
1. Diagnostic criteria
(1) All patients have hand tremors, which makes writing difficult, and tremor can also occur when using the skilled work and tools (left or right), but to a lesser extent.
(2) The physical examination revealed that there was tremor not only in writing but also in the posture of the hand, and there was still non-specific action tremor in the upper limb, which was smaller than writing tremor.
(3) According to the different conditions of hand tremor, the primary writing tremor can be divided into two types, which are limited to tremor when writing, called task-inducing type; there is tremor when writing and maintaining writing posture, called Position sensitive.
2. Exclusion criteria
(1) The appearance of abnormal involuntary posture, such as the posture of dystonia.
(2) Clinical evidence of dystonia or other manifestations of neurological diseases, such as Parkinson's syndrome.
Differential diagnosis
Primary writing sputum is generally considered to be a variant of idiopathic tremor because the frequency of tremor is similar. Primary tremor is accompanied by mild upper limb or motor tremor, and idiopathic tremor Effective drugs can also be used for primary writing tremors.
The onset of idiopathic tremor can only be manifested as unilateral tremor, but as the disease progresses, it can eventually develop into bilateral symmetrical whole body tremor. The primary writing sputum, especially task-induced, usually maintains a relatively stable state. Always keep away from the tremors of your hands.
The primary writing tremor is also considered to be a variant of writing sputum, both of which have task specificity, and the writing sputum also shows a large degree of tremor to some extent. The age of onset of writing sputum is smaller than that of primary writing tremor. ~ 20 years old.
