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Medieval monk with ‘tremulous hand’ finally diagnosed

08 April 2016

BODLEIAN LIBRARIES, UNIVERSITY OF OXFORD

Shaky handwriting: analysis of the 13th-century script has diagnosed “Essential Tremor”

Shaky handwriting: analysis of the 13th-century script has diagnosed “Essential Tremor”

A NERVOUS condition which earned a medieval scribe the title “Tremulous Hand of Worcester” has finally been diagnosed.

The 13th-century writer, whose identity has never been discovered, is believed to have been a monk at Worcester Priory. His work has been readily recognised in about 20 ancient documents by his distinctive shaky handwriting.

Now, an expert on historic manuscripts at the University of York, Dr Deborah Thorpe, and a consultant neurologist with Leeds Teaching Hospitals NHS Trust, Dr Jane Alty, have analysed his script, and conclude that he suffered from an ailment known as “Essential Tremor”.

It is a common movement disorder that today affects about four in 100 adults over 40. It causes uncontrollable shaking of the hands, and is most noticeable when the sufferer tries to hold a position, or attempt a manual task such as writing.

The “Tremulous Hand” was a “glossator” (from the Greek, γλωσσα — glossa — meaning “tongue” or “language”), a select band who specialised in translating sections of ancient manuscripts, and writing commentaries and explanations, either in the margins or within the text. His forte was translating Anglo-Saxon into Middle English.

“He is important, as he is the only widely known medieval writer with a tremor, and for his unusual interest in translating documents written centuries earlier,” Dr Thorpe said. “People have always been fascinated with him; but this is the first time his writing has been investigated from a joint neurological and historical perspective . . . and the first time medieval handwriting has been analysed by a neurologist with a specialist interest in movement disorders.”

The two experts examined a series of the monk’s writings, comparing them with samples from modern-day patients with different conditions that produce shaking. They were also able to follow his condition’s development as he aged, concluding that he was elderly when he wrote his last manuscript.

Their diagnosis was aided by a lack of any indication that his cognitive function was declining, as would happen with Parkinson’s disease or other neurodegenerative disorders. Also, his writing would improve mid-sentence, suggesting that he had revitalised himself with an alcoholic drink, which is known to reduce shaking in essential-tremor sufferers.

The study, which was funded by the Wellcome Trust and the Centre for Chronic Diseases at the University of York, is published in Brain: A journal of Neurology.

http://brain.oxfordjournals.org/content/brain/early/2015/08/31/brain.awv232.full.pdf

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