A patient with comorbid migraine and writer's cramp (focal task-specific dystonia) experienced improvement in both conditions after 3 months of erenumab treatment — the first reported case suggesting CGRP may play a role in dystonia pathophysiology.
First case of CGRP mAb improving dystoniaA patient with writer's cramp saw improvement after 3 months of erenumab, originally prescribed for migraine — no prior reports have linked CGRP antibodies to dystonia improvement
What the researchers found
Erenumab treatment for 3 months improved symptoms of both focal task-specific dystonia (writer's cramp) and migraine in a single patient. This is the first case report of CGRP mAb improving dystonia, suggesting a potential role for CGRP in dystonia pathophysiology.
Why it matters
Writer's cramp and other focal dystonias are difficult to treat — botulinum toxin injections are the main option but have limitations. If CGRP is involved in dystonia pathophysiology, CGRP antibodies could represent an entirely new treatment approach for these debilitating movement disorders.
The numbers in context
First reported case of anti-CGRP mAb improving dystonia. Patient had both migraine and writer's cramp.
How the study worked
Single case report. Patient with comorbid migraine and writer's cramp treated with erenumab (CGRP receptor antibody) due to increasing monthly migraine days. Both conditions assessed clinically before and after 3 months of treatment.
Who was studied
Patient with comorbid migraine and writer's cramp
What this study cannot tell us
Single case report — the lowest level of evidence. Could be coincidental improvement, placebo effect, or natural disease fluctuation. No objective dystonia measures described. Cannot establish causation from a single observation.
How to read the evidence
Rated preliminary: single case report with no control, no objective measures, and potential for coincidental improvement. Important as hypothesis-generating but not evidence for treatment efficacy.
When this study was published
Published in 2024. Represents an emerging observation about CGRP's role beyond pain and migraine.
The bigger picture
CGRP antibodies continue to reveal effects beyond migraine. This case report, while preliminary, suggests CGRP may be involved in the neural circuits that produce dystonia — expanding our understanding of CGRP biology and potentially opening new therapeutic applications for an established drug class.
Questions still open
- Is the dystonia improvement reproducible in other patients with comorbid migraine and focal dystonia?
- Does CGRP play a role in dystonia neural circuits, or was the improvement secondary to migraine reduction?
- Should a prospective trial of CGRP antibodies in focal dystonia patients be pursued?
Common questions
Can CGRP antibodies help with movement disorders like writer's cramp?
What is writer's cramp and how is it usually treated?
Read the original research
Can calcitonin gene-related peptide monoclonal antibodies ameliorate writer's cramp and migraine?
Neuropsychopharmacology reports, 44(2), 482-484
Citation
Suzuki, Keisuke; Suzuki, Shiho; Fujita, Hiroaki; Sakuramoto, Hirotaka; Shioda, Mukuto; Hirata, Koichi. (2024). Can calcitonin gene-related peptide monoclonal antibodies ameliorate writer's cramp and migraine?. Neuropsychopharmacology reports, 44(2), 482-484. https://doi.org/10.1002/npr2.12444