Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector2310.17816/psaic23Clinical analysisКлинический разборUnknownPsychogenic dystoniaПсихогенная дистонияShavlovskayaOlga A.ШавловскаяОльга Александровна
Russian Federation
shavlovskaya@1msmu.ruBaidauletovaА. I.БайдаулетоваА. И.
Kazakhstan
shavlovskaya@1msmu.ruSechenov UniversityФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)Medical Center “Neuroclinic”Медицинский центр «Нейроклиника»02122016104626630012017Copyright ©; 2016, Shavlovskaya O.A., Baidauletova A.I.Copyright ©; 2016, Shavlovskaya O.A., Baidauletova A.I.2016Shavlovskaya O.A., Baidauletova A.I.Shavlovskaya O.A., Baidauletova A.I.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/23

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.

Психогенные двигательная расстройства – сложная «пограничная» проблема современной неврологии, требующая междисциплинарного подхода к решению многочисленных вопросов классификации, диагностики, лечения и реабилитации. В настоящее время к наиболее частым формам психогенных двигательных расстройств относятся тремор, дистония, миоклонус и нарушения походки. В статье описан клинический случай пациента (мужчина 46 лет) с психогенным двигательным расстройством по типу фиксированной дистонии кисти без болевого сопровождения. На представленном примере обсуждаются терминологические вопросы, касающиеся наиболее точного определения данного вида гиперкинеза, а также клинические тесты (стандартные моторные задания, акт письма шариковой ручкой и др.), помогающие установить психогенную природу гиперкинеза. В статье подробно анализируется клиническая феноменология психогенной дистонии, представлены дифференциально-диагностические критерии психогенной и первичной (идиопатической) дистонии.

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