Writer's Cramp in Yaoundé (Cameroon): Series of 5 Cases

Abstract

Writer's cramp is focal dystonia, occurring during writing. Its prevalence is very low in the general population and this pathology therefore considered a rare disease. Its diagnosis is clinical but treatment is still a problem in developing countries because botulinum toxin is not yet available. There is little data in sub-Saharan Africa on writer's cramp. We report a series of 5 cases observed at the Yaounde General Hospital (Cameroon). Methods: We carried out descriptive and prospective work, in which we collected clinical, paraclinical, therapeutic and evolutionary data from patients who came for outpatient consultations for the writer's cramp during 2020 at the Yaounde General Hospital. Results: The prevalence of this pathology in neurology consultation was 0.29%. These were three women and two men, with an average age of 32.8 years. All had non-contributory personal and family backgrounds. They all received a drug treatment based on trihexyphenidyle, muscle relaxants, anxiolytics, associated with physiotherapy. Baclofen was started in the event of failure on trihexyphenidyl, only one patient received botulinum toxin. The outcome was favorable in a single patient, two-thirds of the patients learned to write with the opposite hand. Conclusion: Writer's cramp is an infrequent condition, very often underdiagnosed. It has a real impact on the quality of life because care is difficult, particularly in our context.