Botulinum toxin relieves writer's cramp

doi:10.1136/bmj.334.7588.284-b

BMJ 2007;334:284 (10 February), doi:10.1136/bmj.334.7588.284-b

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Botulinum toxin relieves writer's cramp

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Botulinum toxin type A was better than placeboin a double blind randomised trial of 39 patients with chronicwriter's cramp who were treated over 12 weeks and followed upfor 12 months. Fourteen of 20 (70%) patients receiving botulinumtoxin type A reported benefit and chose to continue treatment(the primary outcome measure), compared with 6 of the 19 (32%)patients given saline injections. Significant improvement wasfound in the scores for patients' assessment of handwriting,symptom severity, and writing speed. Adverse events were confinedto temporary injection pain and hand weakness. The beneficialeffects in those continuing treatment lasted for a mean of 4.7months before further botulinum toxin was indicated. At theend of the trial those who did not improve with placebo wereoffered treatment—9 of 13 having a positive response.Overall about half of patients elected to continue treatmentafter one year (some dropouts resulted . . . [Full text of this article]