Primary writing tremor (PWT) is considered to be a type of task-specific tremor in which tremor predominantly occurs and interferes with handwriting The pathophysiology of PWT is not clear Primary writing tremor may be a variant of essential tremor a type of focal dystonia such as writer s cramp or a separate nosological entity Botulinum toxin injections and deep brain stimulation may be treatment choices for primary writing tremor (C) 2010 Elsevier Ltd All rights reserved