Psychogenic dystonia

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Psychogenic movement disorders pose a complex problem in modern neurology that requires using the interdisciplinary approach to solve a number of questions related to classification, diagnosis, treatment, and rehabilitation. The most frequent forms of psychogenic movement disorders include tremor, dystonia, myoclonus, and gait abnormality. A clinical case of a 46-yearold male patient with psychogenic movement disorder presenting as fixed hand dystonia not accompanied by pain is reported. The terminology issues related to the most accurate determination of this type of hyperkinesis, as well as clinical tests (standard motor-skill tasks, ballpoint pen writing) that allow one to identify the psychogenic nature of hyperkinesis, are discussed using the example provided. The clinical phenomenology of psychogenic dystonia is thoroughly analyzed and the differential diagnostic criteria of psychogenic and primary (idiopathic) dystonia are presented.

About the authors

Olga A. Shavlovskaya

Sechenov University

Author for correspondence.
Russian Federation, Moscow

А. I. Baidauletova

Medical Center “Neuroclinic”

Kazakhstan, Almaty


  1. Baizabal-Carvallo J.F., Fekete R. Recognizing uncommon presentations of psychogenic (func-tional) movement disorders. Tremor Other Hyperkinet Mov (N Y). 2015; 5: 279. doi: 10.7916/D8VM4B13 PMID: 25667816.
  2. Shtul’man D.R., Golubev V.L., Dyukova G.M., et al. [Psychogenic dystonia]. Nevrologicheskii zhurnal. 1997; (3): 34–8. (In Russ.).
  3. Dyukova G.M., Golubev V.L. [Psychogenic movement disorders in historical perspective]. Byulleten’ Natsional’nogo obshchestva poizucheniyu bolezni Parkinsona i rasstroistva dvizhenii. 2012; (1): 21–7. (In Russ.).
  4. Hidasi Z., Salacz P., Csibri E. Movement disorders is psychiatric diseases. Neuropsychopharmacol Hung. 2014; 16 (4): 205–11. PMID: 25577484.
  5. Factor S.A., Podskalny G.D., Molho E.S. Psychogenic movement disorders: frequency, clinical profile, and characteristics. J Neurol Neurosurg Psychiatry. 1995; 59(4): 406–12. PMID: 7561921.
  6. Lang A.E. Psychogenic dystonia: a review of 18 cases. Can J Neurol Sci. 1995 May; 22(2): 136–43. PMID: 7627915.
  7. Shtok V.N., Ivanova-Smolenskaya I.A., Levin OS, editors. Ekstrapiramidnye rasstroistva. Rukovodstvo po diagnostike i lecheniyu [Extrapyramidal disorders. Guide to diagnosis and treat-ment]. Moscow: MEDpress-inform; 2002. 235 p. (In Russ.).
  8. Illarioshkin S.N., Markova E.D., Miklina N.I., Ivanova-Smolenskaya I.A. Molecular genetics of hereditary dystonic syndromes. Journal of Neurology and psychiatry. S. S. Korsakov. 2000; 8: 60–66. (In Russ.) PMID: 10983375.
  9. Illarioshkin S.N. DNK-diagnostika i mediko-geneticheskoe konsul’tirovanie. [DNA diagnosis and medico-genetic counseling]. Moscow: MIA, 2004. (In Russ.).
  10. Slominsky P.A., Markova E.D., Shadrina M.I. et al. A common 3-bp deletion in the DYT1 gene in Russian families with early-onset torsion dystonia. Human Mutation. 1999; 14: 269. doi: 10.1002/ (sici)1098-1004(1999)14:3<269::aid-humu12>; 2–9 PMID: 10477437.
  11. Illarioshkin S.N., Markova E.D., Slominsky P.A. et al. The GTP cyclohydrolase i gene in Russian families with dopa-responsive dysto dystonia. Arch. Neurol. 1998; 55: 789-792. doi: 10.1001/archneur.55.6.789 PMID: 9626769.
  12. Shavlovskaya O.A. Pischiy spazm: klinika, diagnostika, lechenie. Diss. dokt. med. nauk.[Writer’s cramp: clinical features, diagnosis, treatment. Diss. doct. med. sci]. Moscow; 2011. 349 p. (In Russ.).
  13. Jankovic J. «Psychogenic» versus «functional» movement disorders? That is the question. Mov Disord. 2014; 29(13): 1697–8. doi: 10.1002/ mds.26040. PMID: 25255973. 14. La Faver K., Hallett M. Functional or psychogenic: what’s the better name? Mov Disord. 2014; 29(13): 1698–9. doi: 10.1002/mds.26035. PMID: 25242623.
  14. Cras P., Crosiers D. Psychogenic movement disorders. Tijdschr Psychiatr. 2015;57(2):104-8. PMID: 25669947.
  15. Thenganatt M.A., Jankovic J. Psychogenic movement disorders. Neurol Clin. 2015; 33(1): 205–24. doi: 10.1016/j.ncl.2014.09.013. PMID: 25432730.
  16. Edwards M.J., Stone J., Lang A.E. Functional/ psychogenic movement disorders: Do we know what they are? Mov Disord. 2014; 29(13): 1696–7; discussion 1699-701. doi: 10.1002/mds.26039. PMID: 25284581.
  17. Dyukova G.D. Conversion and somatoform disorders in general medical practice. Meditsinskii sovet. 2013; (2): 50–8. (In Russ.).
  18. Dallocchio C., Marangi A., Tinazzi M. Functional or psychogenic movement disorders: an endless enigmatic tale. Front Neurol. 2015; 6: 37. doi: 10.3389/fneur.2015.00037. ECollection 2015. PMID: 25774148.
  19. Edwards M.J., Stone J., Lang A.E. From psychogenic movement disorder to functional movement disorder: it’s time to change the name. Mov Disord. 2014; 29(7): 849–52. doi: 10.1002/mds.25562. PMID: 23843209.
  20. Espay A.J., Lang A.E. Phenotype-specific diagnosis of functional (psychogenic) movement disorders. Curr Neurol Neurosci Rep. 2015; 15(6): 32. doi: 10.1007/s11910-015-0556-y. PMID: 25900093.ICD-10 Version:2016 browse/2016/en#/V
  21. Perezhogin L.O. Somatoformnye rasstroistva. Diagnostika, lechenie, profilaktika. Klinicheskie rekomendatsii [Somatoform disorders. Diagnosis, treatment, prevention. Clinical guidelines]. Moscow; 2015. 22 p. (In Russ.).ICD-11 Beta Draft – Joint Linearization for Mortality and Morbidity Statistics
  22. Fahn S., Olanow C.W. «Psychogenic movement disorders»: They are what they are. Mov Dis-ord. 2014 Jun; 29(7): 853–6. doi: 10.1002/mds.25899 PMID: 24797587.
  23. Hallett M. Functional (psychogenic) movement disorders – Clinical presentations. Parkinsonism Relat Disord. 2016; 22 Suppl 1: S149-52. doi: 10.1016/j.parkreldis.2015. 08.036. PMID: 26365778.
  24. Van der Hoeven R.M., Broersma M., Pijnenborg G.H., et al. Functional (psychogenic) movement disorders associated with normal scores in psychological questionnaires: A case control study. J Psychosom Res. 2015; 79(3): 190–4. doi: 10.1016/j.jpsychores. 2015.06.002. PMID: 26113484.
  25. Hawley J.S., Weiner W.J. Psychogenic dystonia and peripheral trauma. Neurology. 2011 2; 77(5): 496–502. doi: 10.1212/WNL.0b013e3182287aaf. PMID: 21810699.
  26. Ibrahim N.M., Martino D., van de Warrenburg B.P., et al. The prognosis of fixed dystonia: a fol-low-up study. Parkinsonism Relat Disord. 2009; 15(8): 592–7. doi: 10.1016/j.parkreldis.2009.02.010. PMID: 19442561.
  27. Katschnig P., Edwards M.J., Schwingenschuh P., et al. Mental rotation of body parts and senso-ry temporal discrimination in fixed dystonia Mov Disord. 2010; 25(8): 1061–7. doi: 10.1002/mds.23047. PMID: 20310052.
  28. Schrag A., Trimble M., Quinn N., et al. The syndrome of fixed dystonia: an evaluation of 103 patients. Brain. 2004; 127(Pt 10): 2360–72. doi: 10.1093/brain/awh262 PMID: 15342362.
  29. Kamble N.L., Pal P.K. Electrophysiological evaluation of psychogenic movement disorders. Parkinsonism Relat Disord. 2016; 22 Suppl 1: S153–8. doi: 10.1016/j.parkreldis.2015.09.016. PMID: 26403429
  30. Albanese A., Bhatia K., Bressman S.B., et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013; 28(7): 863–73. doi: 10.1002/mds.25475. PMID: 23649720.
  31. Broussolle E., Laurencin C., Bernard E., et al. Early illustrations of geste antagoniste in cervical and generalized dystonia. Tremor Other Hyperkinet Mov (N Y). 2015; 5: 332. doi: 10.7916/D8KD1X74. PMID: 26417535.
  32. Baizabal-Carvallo J.F., Jankovic J. Speech and voice disorders in patients with psychogenic movement disorders. J Neurol. 2015; 262(11): 2420–4. doi: 10.1007/s00415-015-7856-7. PMID: 26194199.
  33. Hinson V.K., Cubo E., Comella C.L., et al. Rating scale for psychogenic movement disorders: scale development and clinimetric testing. Mov Disord. 2005; 20(12): 1592–7. doi: 10.1002/mds.20650 PMID: 16108025.
  34. Honing M.L., Kon M. Dysfunctional postures of the hand as part of a conversion reaction. J Hand Surg Br. 1996; 21(2): 271–5. PMID: 8732418.

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Copyright (c) 2016 Shavlovskaya O.A., Baidauletova A.I.

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