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Dystonia With Secondary Contractures: A Psychogenic Movement Disorder Mimicking Its Neurological Counterpart

Department of Paediatric Neurology, Johann Wolfgang Goethe University, julia.s.ziegler{at}kgu.de

Maya von Stauffenberg, MD

Department of Paediatric Psychosomatic Medicine, Clementine Kinderhospital Frankfurt am Main, Germany

Stefan Vlaho, MD

Department of Paediatric Neurology, Johann Wolfgang Goethe University

Hansjosef Böhles, MD

Center of Paediatrics, Clinic 1 Johann Wolfgang Goethe University

Matthias Kieslich, PhD, MD

Department of Paediatric Neurology, Johann Wolfgang Goethe University

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.

Key Words: psychogenic dystonia • conversion disorder • contracture

Journal of Child Neurology, Vol. 23, No. 11, 1316-1318 (2008)
DOI: 10.1177/0883073808318060


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