title: Psychogenic movement disorder in human T-lymphotropic virus type 1 associated myelopathy.
abstract: Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory disorder of the spinal cord. Acute cases of HAM/TSP and those complicated by movement disorders are rarely reported. Otherwise, psychiatric disturbances are very frequent in infected patients. It can evolve to psychogenic disorders. The case of a 46-year-old woman with acute HAM/TSP complicated by depression and psychogenic movement disorders (chorea of the hands and dystonia-like facial symptoms) is reported. Brain magnetic resonance imaging revealed non-specific small white matter lesions. The involuntary movements arose suddenly and disappeared when the patient was distracted. Two years of psychotherapy and psychiatric follow-up induced complete remission of the symptoms. The association of psychogenic movement disorders and HAM/TSP, increasing the range of neurological manifestations associated with HTLV-1, is related here. Early diagnosis of psychogenic movement disorders is very important to improve the prognosis and treatment of the two conditions, thereby improving the quality of life of HAM/TSP patients and avoiding irreversible sequelae.
authors.affiliation: Neuroinfection Clinic, Hospital Universitário Gaffrée e Guinle (HUGG), Universidade Federal do Estado do Rio de Janeiro (UNIRIO), R. Mariz e Barros, 775, Rio de Janeiro, RJ, CEP 20270-901, Brazil; CSF Laboratory and Post-Graduation in Infectious and Parasitic Diseases, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, Brazil. Electronic address: m_puccioni@yahoo.com.br.
authors.forename: Marzia
authors.initials: M
authors.lastname: Puccioni-Sohler
authors.affiliation: Neuroinfection Clinic, Hospital Universitário Gaffrée e Guinle (HUGG), Universidade Federal do Estado do Rio de Janeiro (UNIRIO), R. Mariz e Barros, 775, Rio de Janeiro, RJ, CEP 20270-901, Brazil.
authors.forename: Jessyca T M A
authors.initials: JTMA
authors.lastname: Ramos
authors.affiliation: CSF Laboratory and Post-Graduation in Infectious and Parasitic Diseases, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Rosadas
authors.affiliation: Movement Disorders Unit, Hospital dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz Felipe
authors.initials: LF
authors.lastname: Vasconcellos
mesh_terms: D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D015493:Paraparesis, Tropical Spastic / Q000150:complications*
keywords: Chorea; Depression; Dystonia; HAM/TSP; Psychogenic movement disorders