Objective: To evaluate the first clinical experience with local botulinum toxin A (BTA) injections in patients with writer's cramp.
Setting: Academic Medical Centre, Amsterdam, the Netherlands.
Method: In May 1993-January 1996 ten patients with writer's cramp were treated with BTA (Dysport). Age of the patients varied from 28 to 68 years, the duration of complaints from 1 to 29 years. Muscles for injections were selected by observation, sometimes combined with electromyography. BTA was administered under electromyographic guidance.
Results: The amount of BTA administered per treatment session ranged from 15 to 400 IU. In three patients the BTA-induced weakness necessary to reach a beneficial effect on writing was unacceptable. In seven patients the response was satisfactory or good and lasted 2 to 15 months (mean: 3.5 months).
Conclusion: The results confirm the efficacy of BTA in writer's cramp.