Disappearance of writing tremor after striatal infarction
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Primary writing tremor (PWT) is a task-specific tremor caused by writing or similar motor activities. It has been characterized as a type of focal dystonia related to writer's cramp as well as a form of essential tremor.1 Disappearance of an essential tremor after stroke has been rarely reported.2 However, cessation of a writing tremor following a stroke has not yet been documented. We describe a patient who had complete resolution of PWT after a discrete contralateral striatal infarction. Increased thalamic inhibition, to the over-activated motor cortex, could be the underlying mechanism for cessation of PWT in such cases.
Case report.
A 70-year-old hypertensive right-handed man was admitted to our hospital with mild right hemiparesis. Prior to admission, the patient reported recurrent right hemiparesis over the prior 2 days with a duration of 5 to 30 minutes. At admission the examination revealed an alert man with a mild right hemiparesis (Medical Research Council Score = 5– out of 5) and no other remarkable neurologic …
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