Dystonia with secondary contractures: a psychogenic movement disorder mimicking its neurological counterpart

J Child Neurol. 2008 Nov;23(11):1316-8. doi: 10.1177/0883073808318060.

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.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Dystonic Disorders / complications*
  • Dystonic Disorders / psychology
  • Female
  • Humans
  • Movement Disorders / complications*
  • Psychophysiologic Disorders / diagnosis*