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


Alty, J and Cosgrove, J and Thorpe, D and Kempster, P, How to use pen and paper tasks to aid tremor diagnosis in the clinic, Practical Neurology, 17, (6) pp. 456-463. ISSN 1474-7758 (2017) [Refereed Article]


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© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1136/practneurol-2017-001719


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 patientís 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.

Item Details

Item Type:Refereed Article
Keywords:Archimedes spiral, dystonia, handwriting, Parkinson's disease, tremor
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Alty, J (Associate Professor Jane Alty)
ID Code:133239
Year Published:2017
Deposited By:Wicking Dementia Research and Education Centre
Deposited On:2019-06-19
Last Modified:2019-08-23
Downloads:18 View Download Statistics

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