[Psychogenic dystonia: report of 2 cases].
Movement disorders have rarely been the result of psychiatric disturbances. Psychogenic dystonia is caracterized by inconsistent findings, a known precipitant factor, onset in legs, pain, multiple somatizations and incongruent association with other movement disorders. We report two patients with clinically established psychogenic dystonia. Patient 1: a female that presented sudden loss of strength in her four limbs; she developed feet dystonia, alternant laterocollis, generalized and irregular tremor, and limb hypertonia that disappeared with distraction; psychological examination showed severe depression, hypochondria and obsessive disorder. Patient 2: a female that presented with irregular limb tremors that disappeared with distraction and left foot dystonia nine years ago; she gradually lost her walk capacity; she complained pain in lumbar area and in her left limb, psychological examination showed infantile behaviour, low frustration tolerance, impulsivity and self-aggression. Their complementary exams showed no alterations and they had no response to specific pharmacological treatment. Dystonia is rarely psychogenic, but this etiology is suggested when clinical characteristics are inconsistent and incongrous with a classical disorder. It should be part of differential diagnosis when appears in association with other somatization or psychiatric disorders.
Serviço de Neurologia, Hospital do Aparelho Locomotor SARAH, Brasília, DF, 70334-900, Brasil.
A P
AP
Vargas
F J
FJ
Carod-Artal
M C
MC
Del Negro
M P
MP
Rodrigues
D000328:Adult; D003863:Depression / Q000150:complications / Q000175:diagnosis; D004421:Dystonia / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D009069:Movement Disorders / Q000523:psychology* / Q000628:therapy; D011379:Prognosis; D013001:Somatoform Disorders / Q000523:psychology* / Q000628:therapy