[Expert assessment of dystonias: changes in scientific consensus with respect to post-traumatic dystonia].
The basis for medical expert reports must always be what is commonly known as the scientific consensus. For some neurological disorders, no more impressive changes in this scientific doctrine can be seen as those made for the dystonias over the last 100 years. The post-traumatic dystonia subsequent to peripheral trauma is an especially impressive example of these changes, as it has been almost completely accepted as a neurological disorder since the 1980 s, having consequences for the practice of medical evaluation and compensation. But since around 2005, voices have been increasingly heard highlighting the psychogenesis, or even the deliberate display of combinations of symptoms. After reviewing the literature, it is arguable if this disorder, as seen from the scientific consensus, exists as an actual disease. The discussion in the context of medical evaluation and the consequences for social medicine and insurance law are the focus of this review.
Medizinisches Gutachteninstitut, Mönckebergstraße 5, Hamburg. fabra@gutachteninstitut.de
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D002490:Central Nervous System / Q000293:injuries; D032921:Consensus; D004421:Dystonia / Q000175:diagnosis* / Q000209:etiology*; D005104:Expert Testimony; D006801:Humans; D007348:Insurance, Health; D008306:Malingering; D059348:Peripheral Nerve Injuries; D012936:Social Medicine; D014947:Wounds and Injuries / Q000150:complications*