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Writer's Cramps, Unable To Sign. Taking Pacitane. What To Do?

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Posted on Wed, 26 Sep 2012
Question: Good evening sir,I am suffering the disease of sevear writers cramps even if i am unable to put my signature since last 8 years and my present age is 43.I am taking pacitane tab by advice of Docter but i have not relief.Pl advice me what to do now.
doctor
Answered by Dr. Sudhir Kumar (28 minutes later)
Hello Mr XXXXXXX XXXXXXX Sahoo,
Thank you for contacting Healthcare Magic.
Writer's cramp is a type of dystonia (abnormal contraction of muscles) affecting the forearms and hands. It is specific to a certain task, in your case it is writing. Symptoms include difficulty in writing, poor handwriting, cramps or pain in the hand/forearm while writing, etc. It is a chronic condition, interfering with normal daily living (even cheques in bank are not accepted as the signatures change/do not match).
Pacitane is a good drug for writer's cramp, but also has some side effects, such as dryness of mouth, sleepiness, etc. Also, it does not give very good relief in some patients (as in your case).
Another medicine useful for writer's cramp is REVOCON (tetrabenazine).
If you do not respond well to pacitane/revocon, you should go for BOTOX injection treatment. In this treatment, botox injections are given in the affected muscles of the forearms. This results in very good improvements and is totally safe. It can be given in OPD setting and you can return home immediately after the procedure.
Please write back if you have any further queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist,
Apollo Hospital, Hyderabad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (23 hours later)
Dear Sir,greetings,many many thanks for your kind responds regarding my diseases.In my present condition I want to take BOTAX injection but in my area there is not available any Neurologist so pl. mail me detail how can I obtain this injection and process of taking the other medicine that is REVOCON and pacitane .please advice me how can any other general particinor inject that injection in which position of my body.
doctor
Answered by Dr. Sudhir Kumar (15 minutes later)
Dear Mr Sahoo,
Thank you for getting back.
BOTOX injection treatment is a specialized procedure, which can only be given by a trained neurologist. So, it may not be possible for you to take it by another doctor. However, if you plan a trip to Hyderabad, I would be pleased to give this injection for you. Several of my patients are from Odisha. It can be completed in one day. Total cost would not exceed Rs. 25,000/
Regarding REVOCON tablets, you can discuss this with your doctor. The usual dose is 25 -50 mg taken twice or thrice daily. Since it is a prescription medication, your doctor should prescribe it for you.
Please get back if you require any additional information.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (39 hours later)
Dear Sir,presently i am taking RIVOTRIL 0.5mg addition with Pacitane since 2days back,if any medicine addition or change with previous medicine like REVOCON please advice me or how can i take per day,please advice me detail wheather i can get relif for my problame.thanking you
doctor
Answered by Dr. Sudhir Kumar (40 minutes later)
Thank you for writing back.
RIVOTRIL may not help much in writer's cramp.
REVOCON is helpful in some cases of writer's cramp. It is usually started at a dose of 25 mg three times daily. Since it is a prescription drug, you have to XXXXXXX your doctor and get it prescribed by him.
However, the best treatment for relief from writer's cramp is BOTOX injections.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX consultant neurologist
Apollo Hospitals,Hyderabad.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

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Writer's Cramps, Unable To Sign. Taking Pacitane. What To Do?

Hello Mr XXXXXXX XXXXXXX Sahoo,
Thank you for contacting Healthcare Magic.
Writer's cramp is a type of dystonia (abnormal contraction of muscles) affecting the forearms and hands. It is specific to a certain task, in your case it is writing. Symptoms include difficulty in writing, poor handwriting, cramps or pain in the hand/forearm while writing, etc. It is a chronic condition, interfering with normal daily living (even cheques in bank are not accepted as the signatures change/do not match).
Pacitane is a good drug for writer's cramp, but also has some side effects, such as dryness of mouth, sleepiness, etc. Also, it does not give very good relief in some patients (as in your case).
Another medicine useful for writer's cramp is REVOCON (tetrabenazine).
If you do not respond well to pacitane/revocon, you should go for BOTOX injection treatment. In this treatment, botox injections are given in the affected muscles of the forearms. This results in very good improvements and is totally safe. It can be given in OPD setting and you can return home immediately after the procedure.
Please write back if you have any further queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist,
Apollo Hospital, Hyderabad