title: Dystonia with secondary contractures: a psychogenic movement disorder mimicking its neurological counterpart.
abstract: 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.
authors.affiliation: Department of Paediatric Neurology, Center of Paediatrics, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. julia.s.ziegler@kgu.de
authors.forename: Julia Stephanie
authors.initials: JS
authors.lastname: Ziegler
authors.forename: Maya
authors.initials: M
authors.lastname: von Stauffenberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Vlaho
authors.forename: Hansjosef
authors.initials: H
authors.lastname: Böhles
authors.forename: Matthias
authors.initials: M
authors.lastname: Kieslich
mesh_terms: D002648:Child; D020821:Dystonic Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D009069:Movement Disorders / Q000150:complications*; D011602:Psychophysiologic Disorders / Q000175:diagnosis*