Micrographia

Introduction Small writing syndrome refers to finger fibrillation during writing, inaccurate movements, and difficulty in small movements. Writing snoring is due to occupational factors for a long time engaged in fine hand movements, resulting in hand muscle spasm, a symptom group mainly based on writing dysfunction. Writingspasm, also known as primary writing tremor (primary writingtremor), is the most common action tremor in adults, especially when writing tremors, making writing difficulties 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, and the tremor of some patients without other dysfunction is not completely limited to writing action. When doing other similar work or using similar tools. There may also be tremors. Therefore, it has been suggested that writing sputum can be divided into task-inducing writing sputum and posture-sensitive writing sputum. Epidemiology: The relevant incidence statistics have not been found. The slow and gradual onset of onset of illness is mainly caused by people who have been writing for 20 to 50 years old. Clinically, it is common for professionals who have been working finely for a long time, such as teachers, editors, secretaries, writers, painters, calligraphers, scribes, drafters, typists, telegraphers, and piano players. The main manifestations are that the fingers are inflexible and uncoordinated; the hand muscles are contracted or the hands are trembling, and even the muscles of the entire arm are shaking, which makes the function of the hands impede and cannot be done by hand; the typical intuitiveness is difficult to grasp with a pen. Writing is skewed, and heavy ones cannot hold pens and writing. This condition is often caused by excessive physical exhaustion (especially the fatigue of the hands) or stress. The more nervous, the more afraid the word is not written well, the more obvious it is. If you change to other things that don't need to be finely manipulated by hand, you will feel calm and operate with ease. The degree of sputum is very light, and it doesn't even happen. Middle-aged and elderly people easily suffer from neurological diseases such as Parkinson's disease or cerebellar ataxia, and symptoms such as finger twitching or tremor may also occur after getting sick. The patients with writing dysentery have sensitive thinking, no facial paralysis, normal fertility, no muscle atrophy, feeling presence, normal reflex, and no abnormal CT scan of the brain, so it is easy to distinguish from the above-mentioned nervous system diseases.

Cause

Cause:

Manganese poisoning can cause small writing problems. This disease is mostly a neurological disease. Some scholars believe that the disease is an extrapyramidal disease or is considered to be a sympathetic reflex disorder.

Pathogenesis:

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 paralytic state. It also has hyperkinetic movement. When you write, your hand muscles and wrist muscles tremble and gradually strengthen your spirit. Tension is more pronounced as a result of active muscles and antagonistic muscle disorders.

an examination

Related inspection

Neurological examination joint examination

(1) All patients have hand tremors, which can cause tremors, but to a lesser extent, when using the (left or right) skilled hands and skilled tools and tools.

(2) The physical examination found that there was tremor not only in writing but also in the posture of the hand, and that the upper limb still had a non-specific action tremor amplitude smaller than the 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.

Differential diagnosis

Writing snoring: It is due to occupational factors that have been engaged in fine hand movements for a long time. From two causes of muscle spasm in the hand, a symptom group mainly characterized by writing dysfunction occurs. The age of onset of writing sputum is 10 to 20 years younger than that of primary tremor.

Primary writing tremor: also accompanied by mild upper limb positional or motor tremor, drugs effective for essential tremor can also be used for primary writing tremor.

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. Primary writing sputum, especially task-inducing, usually remains relatively stable and remains confined to the tremor of the hand.

1. Diagnostic criteria

(1) All patients have hand tremors, which can cause tremors, but to a lesser extent, when using the (left or right) skilled hands and skilled tools and tools.

(2) The physical examination found that there was tremor not only in writing but also in the posture of the hand, and that the upper limb still had a non-specific action tremor amplitude smaller than the 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.

(1) A posture in which an abnormal involuntary posture is expressed as a dystonia.

(2) Clinical evidence of dystonia or other manifestations of neurological diseases, such as Parkinson's syndrome.

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