Immediate and Short-Term Effects of Multimodal Neuromodulatory Rehabilitation Following Thalamotomy for Writer’s Cramp: A Case Report

Background: Evidence for rehabilitation after thalamotomy for writer’s cramp is limited. We report immediate effects of multimodal rehabilitation. Case Report: A woman in her 20s with complex writer’s cramp underwent left Vo/Vim thalamotomy. Postoperatively, she completed a 6-day program combining fine motor training, transcutaneous electrical nerve stimulation, and vibration. Thalamotomy reduced dystonia (Writer’s Cramp Rating Scale [WCRS]: movement, 12 to 4; speed, 2 to 1), and rehabilitation yielded immediate writing speed gains and progressive functional recovery; although WCRS scores remained stable. Discussion: Combining bottom-up neuromodulation with task-specific training was associated with immediate gains, suggesting it may facilitate early motor relearning. Highlights A young woman with writer’s cramp underwent a thalamotomy; followed by early multimodal rehabilitation that combined transcutaneous electrical nerve stimulation, vibratory stimulation, and fine motor training. Video-supported assessments and quantitative measures indicated reproducible within-session gains and short-term improvements in writing time, dexterity, and quality of life.