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Micrographia

MedGen UID:
66806
Concept ID:
C0240341
Finding
SNOMED CT: Micrographia (725122008)
 
HPO: HP:0031908

Definition

Abnormally small-sized handwriting is formally defined as an impairment of fine motor skills, which mainly manifests as a progressive or stable reduction in amplitude during a writing task. [from HPO]

Conditions with this feature

Neuroferritinopathy
MedGen UID:
381211
Concept ID:
C1853578
Disease or Syndrome
Neuroferritinopathy is an adult-onset progressive movement disorder characterized by chorea or dystonia and speech and swallowing deficits. The movement disorder typically affects one or two limbs and progresses to become more generalized within 20 years of disease onset. When present, asymmetry in the movement abnormalities remains throughout the course of the disorder. Most individuals develop a characteristic orofacial action-specific dystonia related to speech that leads to dysarthrophonia. Frontalis overactivity and orolingual dyskinesia are common. Cognitive deficits and behavioral issues become major problems with time.
Autosomal dominant Parkinson disease 1
MedGen UID:
357008
Concept ID:
C1868595
Disease or Syndrome
Parkinson disease is the second most common neurogenic disorder after Alzheimer disease (AD; 104300), affecting approximately 1% of the population over age 50. Clinical manifestations include resting tremor, muscular rigidity, bradykinesia, and postural instability. Additional features are characteristic postural abnormalities, dysautonomia, dystonic cramps, and dementia (Polymeropoulos et al., 1996). For a general phenotypic description and a discussion of genetic heterogeneity of Parkinson disease, see 168600.
Parkinson disease, late-onset
MedGen UID:
463618
Concept ID:
C3160718
Disease or Syndrome
Generally, Parkinson's disease that begins after age 50 is called late-onset disease. The condition is described as early-onset disease if signs and symptoms begin before age 50. Early-onset cases that begin before age 20 are sometimes referred to as juvenile-onset Parkinson's disease.\n\nParkinson's disease can also affect emotions and thinking ability (cognition). Some affected individuals develop psychiatric conditions such as depression and visual hallucinations. People with Parkinson's disease also have an increased risk of developing dementia, which is a decline in intellectual functions including judgment and memory.\n\nOften the first symptom of Parkinson's disease is trembling or shaking (tremor) of a limb, especially when the body is at rest. Typically, the tremor begins on one side of the body, usually in one hand. Tremors can also affect the arms, legs, feet, and face. Other characteristic symptoms of Parkinson's disease include rigidity or stiffness of the limbs and torso, slow movement (bradykinesia) or an inability to move (akinesia), and impaired balance and coordination (postural instability). These symptoms worsen slowly over time.\n\nParkinson's disease is a progressive disorder of the nervous system. The disorder affects several regions of the brain, especially an area called the substantia nigra that controls balance and movement.
Idiopathic basal ganglia calcification 1
MedGen UID:
1637664
Concept ID:
C4551624
Disease or Syndrome
Primary familial brain calcification (PFBC) is a neurodegenerative disorder with characteristic calcium deposits in the basal ganglia and other brain areas visualized on neuroimaging. Most affected individuals are in good health during childhood and young adulthood and typically present in the fourth to fifth decade with a gradually progressive movement disorder and neuropsychiatric symptoms. The movement disorder first manifests as clumsiness, fatigability, unsteady gait, slow or slurred speech, dysphagia, involuntary movements, or muscle cramping. Neuropsychiatric symptoms, often the first or most prominent manifestations, range from mild difficulty with concentration and memory to changes in personality and/or behavior, to psychosis and dementia. Seizures of various types occur frequently, some individuals experience chronic headache and vertigo; urinary urgency or incontinence may be present.
Supranuclear palsy, progressive, 1
MedGen UID:
1640811
Concept ID:
C4551863
Disease or Syndrome
The spectrum of clinical manifestations of MAPT-related frontotemporal dementia (MAPT-FTD) has expanded from its original description of frontotemporal dementia and parkinsonian manifestations to include changes in behavior, motor function, memory, and/or language. A recent retrospective study suggested that the majority of affected individuals have either behavioral changes consistent with a diagnosis of behavioral variant FTD (bvFTD) or, less commonly, a parkinsonian syndrome (i.e., progressive supranuclear palsy, corticobasal syndrome, or Parkinson disease). Fewer than 5% of people with MAPT-FTD have primary progressive aphasia or Alzheimer disease. Clinical presentation may differ between and within families with the same MAPT variant. MAPT-FTD is a progressive disorder that commonly ends with a relatively global dementia in which some affected individuals become mute. Progression of motor impairment in affected individuals results in some becoming chairbound and others bedbound. Mean disease duration is 9.3 (SD: 6.4) years but is individually variable and can be more than 30 years in some instances.

Professional guidelines

PubMed

Coarelli G, Garcin B, Roze E, Vidailhet M, Degos B
J Neurol Sci 2019 Nov 15;406:116454. Epub 2019 Sep 9 doi: 10.1016/j.jns.2019.116454. PMID: 31525530
Gerken A, Wetzel H, Benkert O
Pharmacopsychiatry 1991 Jul;24(4):132-7. doi: 10.1055/s-2007-1014456. PMID: 1754609
Iivanainen M, Laaksonen R, Niemi ML, Färkkilä M, Bergström L, Mattson K, Niiranen A, Cantell K
Acta Neurol Scand 1985 Nov;72(5):475-80. doi: 10.1111/j.1600-0404.1985.tb00904.x. PMID: 4082913

Recent clinical studies

Etiology

Gardoni A, Sarasso E, Agosta F, Filippi M, Corbetta D
Neurol Sci 2023 Aug;44(8):2667-2677. Epub 2023 Mar 25 doi: 10.1007/s10072-023-06752-6. PMID: 36964814
Broeder S, Vandendoorent B, Hermans P, Nackaerts E, Verheyden G, Meesen R, de Xivry JO, Nieuwboer A
J Neurol 2023 Jul;270(7):3442-3450. Epub 2023 Mar 23 doi: 10.1007/s00415-023-11669-3. PMID: 36952012Free PMC Article
Kanno S, Shinohara M, Kanno K, Gomi Y, Uchiyama M, Nishio Y, Baba T, Hosokai Y, Takeda A, Fukuda H, Mori E, Suzuki K
Brain Behav 2020 Aug;10(8):e01669. Epub 2020 Jun 18 doi: 10.1002/brb3.1669. PMID: 32558361Free PMC Article
Rose O
Med Monatsschr Pharm 2016 Jul;39(7):277-81. PMID: 29953178
Jankovic J
J Neurol Neurosurg Psychiatry 2008 Apr;79(4):368-76. doi: 10.1136/jnnp.2007.131045. PMID: 18344392

Diagnosis

Eklund M, Nuuttila S, Joutsa J, Jaakkola E, Mäkinen E, Honkanen EA, Lindholm K, Vahlberg T, Noponen T, Ihalainen T, Murtomäki K, Nojonen T, Levo R, Mertsalmi T, Scheperjans F, Kaasinen V
J Neural Transm (Vienna) 2022 Jul;129(7):895-904. Epub 2022 May 27 doi: 10.1007/s00702-022-02517-1. PMID: 35624405Free PMC Article
Rose O
Med Monatsschr Pharm 2016 Jul;39(7):277-81. PMID: 29953178
Inzelberg R, Plotnik M, Harpaz NK, Flash T
Parkinsonism Relat Disord 2016 May;26:1-9. Epub 2016 Mar 11 doi: 10.1016/j.parkreldis.2016.03.003. PMID: 26997656
Letanneux A, Danna J, Velay JL, Viallet F, Pinto S
Mov Disord 2014 Oct;29(12):1467-75. Epub 2014 Aug 22 doi: 10.1002/mds.25990. PMID: 25156696
Jankovic J
J Neurol Neurosurg Psychiatry 2008 Apr;79(4):368-76. doi: 10.1136/jnnp.2007.131045. PMID: 18344392

Therapy

Gardoni A, Sarasso E, Agosta F, Filippi M, Corbetta D
Neurol Sci 2023 Aug;44(8):2667-2677. Epub 2023 Mar 25 doi: 10.1007/s10072-023-06752-6. PMID: 36964814
Broeder S, Vandendoorent B, Hermans P, Nackaerts E, Verheyden G, Meesen R, de Xivry JO, Nieuwboer A
J Neurol 2023 Jul;270(7):3442-3450. Epub 2023 Mar 23 doi: 10.1007/s00415-023-11669-3. PMID: 36952012Free PMC Article
Rose O
Med Monatsschr Pharm 2016 Jul;39(7):277-81. PMID: 29953178
Wu T, Zhang J, Hallett M, Feng T, Hou Y, Chan P
Brain 2016 Jan;139(Pt 1):144-60. Epub 2015 Nov 2 doi: 10.1093/brain/awv319. PMID: 26525918Free PMC Article
Ma HI, Hwang WJ, Chang SH, Wang TY
Behav Neurol 2013;27(2):169-74. doi: 10.3233/BEN-120285. PMID: 23242350Free PMC Article

Prognosis

Alsehli H, Mosis F, Thompson C, Hamrud E, Wiseman E, Gentleman E, Danovi D
Methods 2021 Jun;190:33-43. Epub 2020 May 21 doi: 10.1016/j.ymeth.2020.05.017. PMID: 32446959Free PMC Article
Coarelli G, Garcin B, Roze E, Vidailhet M, Degos B
J Neurol Sci 2019 Nov 15;406:116454. Epub 2019 Sep 9 doi: 10.1016/j.jns.2019.116454. PMID: 31525530
Boettcher LB, Bonney PA, Smitherman AD, Sughrue ME
Neurosurg Focus 2015 Jul;39(1):E8. doi: 10.3171/2015.4.FOCUS1563. PMID: 26126407
Drotár P, Mekyska J, Rektorová I, Masarová L, Smékal Z, Faundez-Zanuy M
Comput Methods Programs Biomed 2014 Dec;117(3):405-11. Epub 2014 Sep 17 doi: 10.1016/j.cmpb.2014.08.007. PMID: 25261003
Kulkarni O, Lafaver K, Tarsy D
Parkinsonism Relat Disord 2013 Sep;19(9):825-6. Epub 2013 May 7 doi: 10.1016/j.parkreldis.2013.04.013. PMID: 23660546

Clinical prediction guides

Mahlknecht P, Georgiev D, Akram H, Brugger F, Vinke S, Zrinzo L, Hariz M, Bhatia KP, Hariz GM, Willeit P, Rothwell JC, Foltynie T, Limousin P
Brain 2018 Oct 1;141(10):3023-3034. doi: 10.1093/brain/awy217. PMID: 30165511
Zhi N, Jaeger BK, Gouldstone A, Sipahi R, Frank S
IEEE J Biomed Health Inform 2017 Mar;21(2):488-495. Epub 2016 Jan 18 doi: 10.1109/JBHI.2016.2518858. PMID: 26800555
Inzelberg R, Plotnik M, Harpaz NK, Flash T
Parkinsonism Relat Disord 2016 May;26:1-9. Epub 2016 Mar 11 doi: 10.1016/j.parkreldis.2016.03.003. PMID: 26997656
Ma HI, Hwang WJ, Chang SH, Wang TY
Behav Neurol 2013;27(2):169-74. doi: 10.3233/BEN-120285. PMID: 23242350Free PMC Article
Barbarulo AM, Grossi D, Merola S, Conson M, Trojano L
Neuropsychologia 2007 Apr 9;45(8):1685-96. Epub 2007 Jan 13 doi: 10.1016/j.neuropsychologia.2007.01.002. PMID: 17275860

Recent systematic reviews

Gardoni A, Sarasso E, Agosta F, Filippi M, Corbetta D
Neurol Sci 2023 Aug;44(8):2667-2677. Epub 2023 Mar 25 doi: 10.1007/s10072-023-06752-6. PMID: 36964814
Inzelberg R, Plotnik M, Harpaz NK, Flash T
Parkinsonism Relat Disord 2016 May;26:1-9. Epub 2016 Mar 11 doi: 10.1016/j.parkreldis.2016.03.003. PMID: 26997656

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