1992 Volume 19 Pages 11-19
Writer's cramp is considered to be a psychosomatic disorder of the nervous system. It is not infrequently encountered in the clinical setting of psychosomatic internal medicine, but its causes are unclear, and a treatment method has not been established. We have used electromyogram biofeedback method (abbreviated below as EMG-BF) as a method of treating writer's cramp. In this report, we will present the results for patients treated with EM-BF at this Department. The subjects were 20 patients treated with EMG-BF at this Department from April 1986 to March 1990. 15 of the subjects were men, and 15 of them developed the disorder in their 40s and 50s. The average period of illness was 7.2 years, and the clinical types were as follows : 11 cases of the stiffness type, 8 of the trembling type, and 1 of dystonia. The subjects with trembling-type writer's cramp included 3 subjects with phobic tendencies. BF treatment was carried out once weekly for a total of 10 sessions, with feedback being carried out using the myogenic potential of the forearm muscle. The results showed that 65% of the patients reported improvement in subjective symptoms. Improvement rates according to the clinical type were 63.6% for stiffness and 75% for trembling, but excluding the results for the subjects with phobic tendencies, who had a favorable prognosis, the improvement rate for the trembling type was 60%, virtually the same as the rate for the stiffness type. In an objective observation of writing ability after treatment, 85% of the subjects were able to carry out routine writing, and deviation was observed compared to the patients' subjective symptoms. Moreover, the prognosis for the sujects who showed a decrease in myogenic potential due to BF treatment was favorable. Based on these findings, one can conclude that EMG-BF is a method which should be used in treatment of writer's cramp having a mild, chronic course, and it can be considered particularly effective in subjects having phobic tendencies.
