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

Moritoshi Kitakami; Takashi Hoei; Seiji Etoh; Tomoko Hanada; Kentaro Kawamura; Ryosuke Hanaya; Megumi Shimodozono

doi:10.5334/tohm.1154

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

Volume 16 (2026): Issue 1

By: Moritoshi Kitakami , Takashi Hoei, Seiji Etoh, Tomoko Hanada, Kentaro Kawamura, Ryosuke Hanaya and Megumi Shimodozono

Open Access

|Jun 2026

Abstract

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.

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Articles in this issue

DOI: https://doi.org/10.5334/tohm.1154 | Journal eISSN: 2160-8288

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Language: English

Page range: 36 - 36

Submitted on: Dec 22, 2025

Accepted on: Apr 2, 2026

Published on: Jun 3, 2026

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

transcutaneous electrical nerve stimulation,

vibration

© 2026 Moritoshi Kitakami, Takashi Hoei, Seiji Etoh, Tomoko Hanada, Kentaro Kawamura, Ryosuke Hanaya, Megumi Shimodozono, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 16 (2026): Issue 1