Dystonia with secondary contractures: a psychogenic movement disorder mimicking its neurological counterpart.
We report the case of an 11-year-old girl presenting with a 1.5-year history of swan neck-like deformed joint contractures of both hands. A possible diagnosis was sought in a wide range of rheumatological, metabolic, and neurological disorders. After detailed diagnostic procedures to exclude an organic pathology, steps were taken to establish a psychogenic origin. She showed symptoms that were incongruent with an organic neurological disorder, for example, a paroxysmal fluctuating course, reaction to placebo, and complete remission with psychotherapy and physiotherapy. The psychosomatic evaluation revealed a highly emotional conflict. This bizarre case demonstrates that secondary contractures are by no means an exclusion criterion for a psychogenic dystonia.
Ziegler
Julia Stephanie
JS
Department of Paediatric Neurology, Center of Paediatrics, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. julia.s.ziegler@kgu.de
von Stauffenberg
Maya
M
Vlaho
Stefan
S
Böhles
Hansjosef
H
Kieslich
Matthias
M
D002648:Child; D020821:Dystonic Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D009069:Movement Disorders / Q000150:complications*; D011602:Psychophysiologic Disorders / Q000175:diagnosis*