Psychogenic Dystonia in Tunisian Children


Psychogenic dystonia in children is rare and often difficult to distinguish from organic dystonia. It is usually related to a psychological or psychiatric underlying cause. From January 2004 to November 2009, 5 children with psychogenic dystonia among 200 with dystonia were followed up in our department. Elements of history, physical examination, videotaping and management were analyzed. Mean age was 14.9 years, mean age of onset was 13 years and mean follow up period was 6 months. The dystonia onset was abrupt in 3 patients and progression resulted rapidly into fixed dystonia in 4 patients. Pain was observed in all patients. Paroxysmal dystonia was observed in one patient. An underlying psychiatric disorder was found in all patients. All patients improved with psychotherapy and anxiolytic or antidepressant drugs. Only one patient showed relapse after each familial conflicts. The small size of our series reflects this disorder is rare (1 case/year). Pain was a prominent feature in all patients. Children have acute onset, short duration of disease and improved under psychological therapy and drugs. Psychogenic dystonia in children is usually misdiagnosed. It is necessary to analyze clinical features and outcome of this disorder to reach a clear diagnosis and adequate management, which requires multifaceted approach, including psychological, physical and pharmacological therapies.

Share and Cite:

H. Ben Rhouma, I. Kraoua, J. Yacoubi, N. Fradj and N. Gouider-Khouja, "Psychogenic Dystonia in Tunisian Children," Journal of Behavioral and Brain Science, Vol. 2 No. 2, 2012, pp. 191-194. doi: 10.4236/jbbs.2012.22023.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] S. Fahn and D. T. Williams, “Psychogenic Dystonia,” Advances in Neurology, Vol. 50, 1988, pp. 431-55.
[2] J. Ferrara and J. Jankovic, “Psychogenic Movement Disorders in Children,” Movement Disorders, Vol. 23, No. 13, 2008, pp. 1875-1881. doi:10.1002/mds.22220
[3] P. Schwingenschuh, C. Pont-Sunyer, R. Surtees, et al., “Psychogenic Movement Disorders in Children: A Report of 15 Cases and a Review of the Literature,” Movement Disorders, Vol. 23, No. 13, 2008, pp. 1882-1888. doi:10.1002/mds.22280
[4] S. Ertan, D. Uluduz, G. Kiziltan, et al., “Clinical Characteristics of 49 Patients with Psychogenic Movement Disorders in a Tertiary Clinic in Turkey,” Movement Disorders, Vol. 24, No. 5, 2009, pp. 759-762. doi:10.1002/mds.22114
[5] A. Gupta and A. E. Lang, “Psychogenic Movement Disorders,” Current Opinion in Neurology, Vol. 22, No. 4, 2009, pp. 430-436. doi:10.1097/WCO.0b013e32832dc169
[6] E. L. Peckham and M. Hallett, “Psychogenic Movement Disorders,” Neurologic Clinics, Vol. 27, No. 3, 2009, pp. 801-819. doi:10.1016/j.ncl.2009.04.008
[7] M. A. Ahmed, A. Martinez, A. Yee, et al., “Psychogenic and Organic Movement Disorders in Children,” Development Medicine & Child Neurology, Vol. 50, No. 4, 2008, pp. 300-304. doi:10.1111/j.1469-8749.2008.02043.x
[8] A. Schrag, M. Trimble, N. Quinn, et al., “The Syndrome of Fixed Dystonia: An Evaluation of 103 Patients,” Brain, Vol. 127, No. 10, 2004, pp. 2360-2372. doi:10.1093/brain/awh262
[9] R. Surtees, “Functional Movement Disorders in Childhood. Movement Disorders in Children: A Clinical Update with Video Recordings,” N. Fernandez-Alvarez, Eds., John Libbey Eurotext, Montrouge, 2007, pp. 145-151.
[10] T. Pringsheim and A. E. Lang, “Psychogenic Dystonia,” Reviews Neurology, Vol. 159, 2003, pp. 885-891.
[11] D. Kirsch and J. W. Mink, “Psychogenic Movement Disorders in Children,” Pediatric Neurology, Vol. 30, 2004, pp. 1-6. doi:10.1016/j.pediatrneurol.2003.07.001
[12] A. Majumdar, J. Lopez-Casas, P. Poo, et al., “Syndrome of Fixed Dystonia in Adolescents-Short Term Outcome in 4 Cases,” European Journal of Paediatric Neurology, Vol. 13, No. 5, 2009, pp. 466-472. doi:10.1016/j.ejpn.2008.09.005

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.