title: Post-traumatic shoulder movement disorders: A challenging differential diagnosis between organic and functional.
abstract: Peripheral trauma may be a trigger for the development of various movement disorders though the pathophysiology remains controversial and some of these patients have a functional (psychogenic) disorder. We report 3 cases of shoulder movement disorders following trauma to the shoulder region. Physiology was done in all the patients to extend the physical examination. Two patients had history of recurrent shoulder dislocation and were diagnosed with Ehlers-Danlos syndrome. One patient had shoulder injury following repeated falls while performing as a cheerleader. In two patients there were some clinical features suggesting a functional etiology, but physiological studies in all three failed to produce objective evidence of a functional nature. Shoulder movement following trauma is uncommon. Diagnosis in such cases is challenging considering the complex pathophysiology. The movements can be associated with prolonged pain and handicap, and once established they appear resistant to treatment.
authors.affiliation: Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, United States of America, 20892 ; Govind Ballabh Pant Hospital, New Delhi, India 110002.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pandey
authors.affiliation: University of California San Diego.
authors.forename: Fatta
authors.initials: F
authors.lastname: Nahab
authors.affiliation: Department of Neurology, Gundersen Health System La Crosse, WI 54601-5467.
authors.forename: Jason
authors.initials: J
authors.lastname: Aldred
authors.affiliation: Oregon Health & Science University Department of Neurology.
authors.forename: John
authors.initials: J
authors.lastname: Nutt
authors.affiliation: Govind Ballabh Pant Hospital, New Delhi, India 110002.
authors.forename: Mark
authors.initials: M
authors.lastname: Hallett
keywords: Functional; Movement; Physiology; Psychogenic; Shoulder; Tremor