A case of psychogenic movement disorder unresponsive to psychopharmacological treatment

Abstract

Psychogenic movement disorders (PMD) are movement disorders for which an etiology cannot be found after exclusion of organic causes. These movement disorders can perfectly mimic organic movement disorders. Clinical observations, detailed medical history and neurological examination can help diagnose this condition. We present a 45 years old man with weakness in his right leg for two years which was evident especially during a walk. His physical examination showed that during initiation of walk dystonic posturing occurred for a few seconds and this caused gait disturbance. Laboratory and radiological tests for differential diagnosis did not reveal any abnormal finding. Diagnosis of PMD was made based on these results. Psychotropic medications and cognitive behavioral therapy failed to produce any response. In conclusion both diagnosis and treatment of PMD pose a great challenge for clinician. This diagnosis should be kept in mind in order to avoid adverse consequences of wrong diagnoses and unnecessary treatments.