Objective: We present a case series of task-specific dystonia that occurs exclusively when typing in three software engineers.
Background: Task-specific dystonia refers to abnormal involuntary contraction of muscles only during a particular motor task. Focal hand dystonia related to one’s occupation can be debilitating and career limiting. Here we identify three software engineers, with unilateral hand posturing when typing.
Method: All of these cases had otherwise normal neurological exams with no findings of dystonia in any body part. Dystonic posturing was only noted during typing.
Case 1 is a left-handed 28-year-old man with involuntary left 3rd, 4th and 5th proximal interphalangeal joint flexion that emerges within 30 seconds of typing.
Case 2 is a right-handed 26-year-old man with irregular 5-7Hz oscillations involving the left wrist in flexion/extension plane with radial deviation of left wrist and left 5th metacarpophalangeal joint extension when typing.
Case 3 is a right-handed male with known essential tremor since his teens, who at the age of 52 developed left 3rd, 4th and 5th proximal interphalangeal joint flexion and wrist pronation while typing.
Results: In all patients, MRI brain and EMG/NCS showed no abnormalities.
Case 1 patient did not benefit from occupational therapy, with interventions tried including splinting/taping, rest breaks, hand exercises, and adjustments in typing speed. Medications including trihexyphenidyl and baclofen were ineffective. He received onabotulinum toxin A injections of the flexor digitorum superficialis (FDS) and profundus (FDP) muscles of the affected digits, without improvement, and did not pursue further treatment.
Case 2 patient was prescribed carbidopa-levodopa, which did not improve his symptoms. He was referred to occupational therapy, with improvement in left hand dexterity while using a weighted glove.
Case 3 patient received onabotulinum toxin A injections of the FDS and FDP muscles of affected digits, with mild hand weakness. His injection pattern was subsequently adjusted, with removal of FDP injections, and he has since had excellent response to his dystonia.
Conclusion: We present a series of three cases to illustrate a new phenomenology we term “Coder’s Cramp”, with task specific focal dystonia affecting software engineers, that occurs only when typing.
To cite this abstract in AMA style:
R. Voshtina, S. Barton, J. Ng. “Coder’s Cramp”: A Case Series of Task- Specific Typing Dystonia [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/coders-cramp-a-case-series-of-task-specific-typing-dystonia/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/coders-cramp-a-case-series-of-task-specific-typing-dystonia/