INCREASED WRITING ACTIVITY IN NEUROLOGICAL CONDITIONS - A REVIEW AND CLINICAL-STUDY

Increased writing activity in a 70 year old, right handed man presenti ng with a history of alcohol misuse and maturity onset diabetes is rep orted. Brain CT disclosed corticosubcortical atrophy and Tc-99m-HMPAO SPECT disclosed severe bilateral frontal hypoperfusion more prominent on the right. The patient's neuropsychological symptomatology consiste d of severe (verbal) aspontaneity, intermittent utilisation behaviour, and pronounced increased writing activity, which mainly consisted of a perseverative, micrographic written reproduction of visually or verb ally perceived language fragments. Several neurological causes of incr eased writing activity and the equivocal terminology met in the medica l literature are reviewed. A distinction between hypergraphia and auto matic writing behaviour is proposed. It is concluded that our patient' s increased writing activity may be characterised as automatic writing behaviour.