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Small handwriting
    Differential Diagnosis[Top] [Nav]
parkinsonism, macropsia, hemiplegia and other corticospinal conditions
    Discussion -- not available online[Top] [Nav]
    Update Comments[Top] [Nav]
  • Notes that macropsia and micropsia may be features of partial epilepsy. [101]
  • Metronome helps parkinsonian persons walk. [102]
  • "Micropnée" is the respiratory analog of micrographia. [103]
  • Half tongue-in-cheek, defines graphataxia as "a mixture of capital and lower case letters within the same text with a definite lack of consistency." Notes that afflicted persons have an agnosia about it, strongly denying there is anything wrong with their writing. Also claims that only American-educated persons are ever afflicted. [104]
  • Dr. James G. Peden of East Carolina University School of Medicine states that the most telling sign of substance abuse in a physician may be a sudden deterioration in handwriting style and legibility. This was never published in a peer-reviewed journal (as of 970912), so caveat emptor. [105]
  • Wilson described small writing in parkinsonism, so it is nicely symmetric that this paper describes "wobbly" handwriting in Wilson disease! The patient's penmanship improved after treatment. [106]
    Footnotes in Print Edition[Top] [Nav]
    (1) The Croonian lectures on some disorders of motility and of muscle tone, with special reference to the corpus striatum.
  Wilson SAK.   Lancet. 1925;II:1-10, 53-62, 169-178, 215-219, 268-279.
    (2) Neurology.
  Wilson SAK, Bruce AN. Baltimore: Williams & Wilkins, 1940: 120.
    (3) Dysmetropsia and its pathogenesis.
  Wilson SAK.   Trans Ophthal Soc UK. 1916;412-444.
    (4) De la micrographie dans les États Parkinsoniens postencéphalitiques et des conditions qui sont susceptibles de la modifier.
  Froment MF.   Rev Neuro. 1921;37:635-638.
    (5a) Adolph Hitler: his diaries and Parkinson's disease [letter].
  Lieberman AN.   N Engl J Med 1983 Aug 11;309(6):375-6.  Pubmed  Similars
    (5b) More on Hitler and Parkinson's disease [letter].
  Friedman EH.   N Engl J Med 1987 Jan 8;316(2):114.  Pubmed  Similars
    New References[Top] [Nav]
Macropsia
    101.Current concepts in neurology. Partial epilepsy.
  Schomer DL.   N Engl J Med 1983 Sep 1;309(9):536-9.  Pubmed  Similars
Parkinsonism
    102.Metronome in Parkinson's disease [letter].
  Enzensberger W, Fischer PA.   Lancet 1996 May 11;347(9011):1337.  Pubmed  Similars
    103.Etats Parkinsoniens liés à l'encéphalite.
  Beriel L.   Rev Neuro. 1921;37:673-675.
Other handwriting syndromes
    104.Graphataxia [letter].
  Benbadis SR.   Ann Intern Med 1990 Aug 1;113(3):257.  Pubmed  Similars
    105.Subtle clues suggest substance abuse in physicians.
  Anonymous.   Int Med News. 1-14 April 1990;23(7):15.
    106.Wobbly handwriting.
  del Rosario MA, Davis MM, et al.   Lancet 1998 Jan 31;351(9099):336.  Pubmed  Similars
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:34 PDT on July 4, 2000.[Top]

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