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Handwriting difficulties in adults - NICE guidance - suspected neurological conditions - recognition and referral

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Handwriting difficulties in adults

Summary points from NICE guidance relating to handwriting difficulties in adults are:

  • refer adults who have sudden-onset difficulty with handwriting that has no obvious musculoskeletal cause for a neurological assessment according to local stroke pathways

  • ask adults who have difficulty with handwriting that has no obvious musculoskeletal cause to demonstrate their handwriting and:

    • if they have a problem with generating language rather than hand function, refer for neurological assessment

    • if their handwriting is small (micrographia) and slow, consider referring for possible Parkinson's disease

    • if their difficulty is specific to the task of handwriting and examination shows no other abnormalities, consider referring for possible focal dystonia

Reference:

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