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Objectives: The aim of the paper was to: (1) evaluate the effectiveness of the physiotherapeutic program in writer’s cramp, (2) compare the brain activity while writing in patients with writer’s cramp and in healthy controls, (3) compare the brain activity of subjects with writer’s cramp before and after the physiotherapy. Material and methods: Nine patients with diagnosed writer’s cramp and nine age-matched healthy controls were studied. The functional magnetic resonance imaging while writing was performed in the writer’s cramp subjects and in the controls. The patients with writer’s cramp participated in a 3-week therapeutic program of individualised exercises in combination with the immobilisation of the affected limb. The functional magnetic resonance imaging was repeated after completing the therapeutic program. Results: Only the results of the coil drawing test significantly improved after completing the therapeutic program. All other clinical tests did not reveal any significant changes after the therapy. Activation of primary motor cortex, premotor cortex and primary sensory cortex was observed while writing in the subjects with writer’s cramp and in the controls. Brain activation in clusters located in the areas BA4, BA7, BA18 and BA37 was more pronounced in the writer’s cramp group. Individual analysis revealed a significantly increased activation of the cerebellum in the writer’s cramp patients and it decreased after physiotherapy. Conclusion: In the writer’s cramp subjects, functional magnetic resonance imaging revealed increased – when compared to the controls – activity of several brain structures while writing. This activity was modified by individualised physiotherapeutic program.

Objectives: The purpose of our study was to determine the probability of developing Parkinson’s disease in various syndromes of isolated tremor. Material and methods: We performed a retrospective analysis of the diagnostic process in patients with isolated upper limb tremor where single-photon emission computed tomography (SPECT)-DaTSCAN was performed. Twenty-four consecutive subjects (9 males, 15 females) with isolated tremor of one or both upper limbs were studied. The patients were referred for SPECT by neurologists from various centres. Cases of diagnosed structural, metabolic or druginduced tremor were not included in the study. All patients were examined by a movement disorder specialist before and 1–3 years after SPECT-DaTSCAN. All subjects were classified according to the Consensus Statement on the Classification of Tremors (2018). Results: The lowest probability of developing Parkinson’s disease was found in patients with rest and action (postural and kinetic) tremor, both unilateral and bilateral. The risk was also low in subjects with postural and kinetic tremor. In cases of a combination of rest and postural tremor (both unilateral and bilateral), the likelihood of neurodegenerative parkinsonism was high. Conclusion: Performing SPECT-DaTSCAN in selected cases of isolated of tremor with a high probability of Parkinson’s disease avoids the unnecessary use of drugs recommended in the therapeutic algorithms applicable in essential tremor.