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Micrographia causes small, cramped handwriting. It often worsens as one continues to write in a single sitting.
Micrographia is one of the potential motor symptoms of Parkinson’s disease, although small handwriting alone does not diagnose Parkinson’s.
Here’s what you need to know about micrographia, including why it happens in Parkinson’s and how to manage this symptom in day-to-day life.
The prefix “micro-” means “small,” and the suffix “-graphia” refers to writing. A person with micrographia writes unusually small letters and words that are very close together. Some people with micrographia find that their handwriting gets smaller and smaller the longer they write without a break.
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Micrographia can be one of the early symptoms of Parkinson’s. “My handwriting was my first indicator of Parkinson’s,” one MyParkinsonsTeam member shared. “That was 11 years ago, and now my writing is totally illegible.”
A study of 68 men with Parkinson’s disease found that about half of them experienced micrographia. Micrographia appears to be closely correlated with both hypophonia (soft, quiet speech) and bradykinesia (slowed movement), two common symptoms of Parkinson’s.
Micrographia results from the same changes in the brain that cause other Parkinson’s symptoms. Parkinson’s is a neurodegenerative disorder characterized by damage to a part of the brain called the basal ganglia. Loss of brain cells that produce dopamine makes motor activity difficult, and this includes handwriting.
Other motor symptoms can also make it harder to write. If your body moves slower than it used to, you experience tremors or shaking, or your movement is rigid, your handwriting may be affected.
In a survey of MyParkinsonsTeam members, 40 percent of respondents said this symptom affects their daily life.
Members describe how their handwriting interferes with work, daily routines and hobbies, and paying bills or signing important documents.
Handwriting that is difficult to read can become a problem at work for some members:
Members have shared that changes to their handwriting can make certain tasks more difficult and affect how they take part in hobbies.
Micrographia can cause a person’s signature to change over time. Significant differences may affect certain legally binding documents.
Members shared:
For some members, difficulty signing their name makes it hard for them to send
holiday or birthday cards. While this doesn’t pose legal problems, it can be discouraging.
Several strategies can help improve your handwriting and combat micrographia. Talk with your neurologist or another healthcare provider to help determine the best options for you.
Your neurologist may recommend handwriting therapy with an occupational therapist.
Neuroscientists report that handwriting training with specific writing exercises can improve writing size, though people may not be able to write faster and there may be other costs associated with this training. For instance, people who learned to write larger letters seemed to learn to focus on that at the expense of other aspects of having good handwriting.
Handwriting therapy may also improve the way some neurons function in the brain. Many people with Parkinson’s maintain these improvements for at least six weeks after therapy.
Some members have had great success with these interventions. As one shared, “I received a DVD from my movement disorder specialist that had recommendations for handwriting practice. I have made practicing my handwriting part of my exercise, stretching, and therapy. I have seen an improvement with my writing.”
Some personal penmanship habits may be making it harder for you to write. Changing your habits may feel like relearning how to write, but practicing a few techniques can improve legibility.
If you’re not sure where to start, occupational therapy can help.
Consider adopting the following writing habits:
“I now use printed rather than cursive script. I find I have much better control,” one member said. “Also, I use a ballpoint pen with a large nib rather than a fine one. Felt ink pens that are midrange also work very well but can be a bit heavy for certain things.”
If your handwriting isn’t improving or you need a quick solution to jump-start practicing, technology can help.
One member explained, “I have a tablet where I type out what I need, my poems, and my stories. Then it prints out my lists, letters, stories, emails, etc., so they are legible for others to read.”
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Be it writing or walking or anything else, I do better when I am slow and deliberate. I often have to ask people to please be patient with me for being so slow, but it is usually me who is so… read more
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