• How to use pen and paper tasks to aid tremor diagnosis in the clinic

    Author(s):
    Jane Alty, Jeremy Cosgrove, Peter Kempster, Deborah Thorpe (see profile)
    Date:
    2017
    Subject(s):
    Medicine
    Item Type:
    Article
    Tag(s):
    Medieval, neurology, medicine
    Permanent URL:
    http://dx.doi.org/10.17613/M6CB9D
    Abstract:
    When a patient presents with tremor, it can be useful to perform a few simple pen and paper tests. In this article, we explain how to maximise the value of handwriting and of drawing Archimedes spirals and straight lines as clinical assessments. These tasks take a matter of seconds to complete but provide a wealth of information that supplements the standard physical examination. They aid the diagnosis of a tremor disorder and can contribute to its longitudinal monitoring. Watching the patient’s upper limb while they write and draw may reveal abnormalities such as bradykinesia, dystonic posturing and distractibility. The finished script and drawings can then be evaluated for frequency, amplitude, direction and symmetry of oscillatory pen movements and for overall scale of penmanship. Essential, dystonic, functional and parkinsonian tremor each has a characteristic pattern of abnormality on these pen and paper tests.
    Metadata:
    Published as:
    Journal article    
    Status:
    Published
    Last Updated:
    5 years ago
    License:
    Attribution-ShareAlike
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