Treatment of primary writing tremor with botulinum toxin type a injections: report of a case series

Clin Neuropharmacol. Nov-Dec 2006;29(6):364-7. doi: 10.1097/01.WNF.0000236765.00785.9C.


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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Botulinum Toxins, Type A / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuromuscular Agents / therapeutic use*
  • Tremor / drug therapy*
  • Writing*


  • Neuromuscular Agents
  • Botulinum Toxins, Type A