Öz
After ruling out of organic causes, movement disorders are named as psychogenic movement disorders, it can mimic perfectly Organic movement disorders, but with a good history, clinical observations and detailed examination is very helpful in the diagnosis of this disease. In here we will present a 15 years old male patient, he was complaining of urinary incontinence at night, emerging dystonic posture especially in crowded environments, eating, and during activities that require attention, for 5 years. Self and family history was unremarkable. His physical and neurological examination was normal except for dystonic posture esipecially writing and when doing skilled jobs. All the tests were normal for the differential diagnosis. Taking into account the patient's clinical findings and cilinical test, the patient was diagnosed as psychogenic dystonia. He gave a very good response to treatment with antidepressants and psychotherapy. As a result, in clinical practice both the diagnostic and therapeutic challenges the psychogenic movement disorders is an important problem, and to get rid of the negative effects of unnecessary diagnostic test and side efects of treatment, you need to keep in mind this diagnosis.
Anahtar Kelimeler
Kaynakça
- Factor S, Podskalny G, Molho E. Psychogenic movement disorders: frequency,clinical profile, and characteristics.J Neurol Neurosurg Psychiatry 1995; 59: 406-12.
- Marjama J, Troester AI, Koller WC. Psychogenic Movement Disorders. Neurologic Clinics 1995; 13:283-297.
- Ray L. Watts, William C. Koller, Movement Disorder, second edition, McGraw-Hill Medical Publishing 2004; s 891-910.
- Berardelli A, Roth well JC, Hal lett M, Thompson PD, Man fre di M, Mars den CD. The pat hophysiology of primary dystonia. Brain 1998;121(Pt 7):1195-212.
- Gü rer YKY, Yüksel D. [Child hood dystonia]. Turkiye Klinikleri J Pediatr Sci 2006;2(8):16-23.
- Behrman RE. Movement disorders. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed.Philadelphia: WB Saun ders; 2000. p.1839-43.
- Dooley JM, Furey S, Gordon KE, Wood EP.Fever-induced dystonia. Pediatr Neurol 2003;28(2):149-50.
- Senecky Y, Lobel D, Diamond GW, We itz R,Inbar D. Isolated orofacial dyskinesia: a methylphenidate-induced movement disorder.Pediatr Neurol 2002;27(3):224-6.
- Couprie W, Wijdicks EF, Rooijmans HG ve ark.. Outcome in conversion disorder: a follow up study. J Neurol Neurosurg Psychiatry 1995; 58: 750-752.
- Vanessa K Hinson, W Blake Haren Psychogenic movement disorders Lancet Neurol 2006; 5: 695-700
- Williams DT, Ford B, Fahn S. Phenomenology and psychopathology related to psychogenic movement disorders. Adv Neurol 1995; 65: 233-57.
- Voon V, Lang A. Antidepressant outcomes of psychogenic movement disorders. J Clin Psychiatry 2005; 66: 1529–34.
Öz
Organik nedenler dışlandıktan sonra herhangi bir nedene bağlanamayan hareket bozuklukları Psikojen hareket bozuklukları olarak adlandırılır, organik hareket bozukluklarını mükemmel bir şekilde taklit edebileceği gibi bunlardan ayrıt etmeye yarayacak kilit noktalarda mevcuttur, iyi bir anamnez, klinik gözlem ve detaylı muayene bu hastalığın tanısını koymaya çok yardımcı olur. Burada 15 yaşında 5 yıldır ellerinde özellikle kalabalık ortamlarda, yemek yerken, iş yaparken ortaya çıkan distonik postur ve geceleri idrar kaçırma şikayetiyle başvuran erkek bir hasta sunulacaktır. Öz ve soy geçmişlerinde özellik olmayan hastanın Fizik ve Nörolojik muayenesinde ellerde özellikle yazı yazarken ve beceri gerektiren işleri yaparken belirginleşen distonik postür haricinde anormallik saptanmadı. Ayırıcı tanılara yönelik yapılan tüm tetkikler normal olarak sonuçlandı. Yapılan tetkikler ve hastanın klinik bulguları göz önüne alınarak hastaya psikojen distoni tanısı konuldu. Verilen antidepresan ve yoğun telkin tedavisine çok iyi yanıt alındı.
Sonuç olarak klinik pratikte hem tanı hem de tedavi zorlukları bulunan psikojen hareket bozuklukları önemli bir problemdir ve gereksiz tanı ve tedavilerin olumsuz etkilerinden kurtulmak için bu tanıyı akılda tutmak gerekir.
Anahtar Kelimeler
Kaynakça
- Factor S, Podskalny G, Molho E. Psychogenic movement disorders: frequency,clinical profile, and characteristics.J Neurol Neurosurg Psychiatry 1995; 59: 406-12.
- Marjama J, Troester AI, Koller WC. Psychogenic Movement Disorders. Neurologic Clinics 1995; 13:283-297.
- Ray L. Watts, William C. Koller, Movement Disorder, second edition, McGraw-Hill Medical Publishing 2004; s 891-910.
- Berardelli A, Roth well JC, Hal lett M, Thompson PD, Man fre di M, Mars den CD. The pat hophysiology of primary dystonia. Brain 1998;121(Pt 7):1195-212.
- Gü rer YKY, Yüksel D. [Child hood dystonia]. Turkiye Klinikleri J Pediatr Sci 2006;2(8):16-23.
- Behrman RE. Movement disorders. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed.Philadelphia: WB Saun ders; 2000. p.1839-43.
- Dooley JM, Furey S, Gordon KE, Wood EP.Fever-induced dystonia. Pediatr Neurol 2003;28(2):149-50.
- Senecky Y, Lobel D, Diamond GW, We itz R,Inbar D. Isolated orofacial dyskinesia: a methylphenidate-induced movement disorder.Pediatr Neurol 2002;27(3):224-6.
- Couprie W, Wijdicks EF, Rooijmans HG ve ark.. Outcome in conversion disorder: a follow up study. J Neurol Neurosurg Psychiatry 1995; 58: 750-752.
- Vanessa K Hinson, W Blake Haren Psychogenic movement disorders Lancet Neurol 2006; 5: 695-700
- Williams DT, Ford B, Fahn S. Phenomenology and psychopathology related to psychogenic movement disorders. Adv Neurol 1995; 65: 233-57.
- Voon V, Lang A. Antidepressant outcomes of psychogenic movement disorders. J Clin Psychiatry 2005; 66: 1529–34.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Temmuz 2014 |
| Yayımlandığı Sayı | Yıl 2014 Cilt: 4 Sayı: 1 |