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精神性运动障碍:步态是关键线索!

Psychogenic Movement Disorders: Gait Is a Give-Away!

作者信息

Balint Bettina, van Winsen Lisa M L, Bhatia Kailash P, Bloem Bas R

机构信息

Department of Neurology Medical University Heidelberg Heidelberg Germany.

Institute of Neurology University College London London United Kingdom.

出版信息

Mov Disord Clin Pract. 2014 May 26;1(2):110-111. doi: 10.1002/mdc3.12031. eCollection 2014 Jun.

Abstract

The aim of this article is to point out that an incongruity of gait disorder (either in relation to the presenting movement disorder or incongruity with any type of organic gait disorder) is a useful clue in diagnosing psychogenic movement disorders. To illustrate this, we present a case series of patients with various types of psychogenic movement disorders (rest tremor, myoclonus, dystonia, and chorea). Incongruity of the walking pattern with the presenting movement disorder was a revealing diagnostic clue in all cases. "Incongruity" is currently a main plank in the diagnosis of psychogenic conditions. Our series emphasizes that incongruity of the gait pattern may be the most important sign in a patient where it is otherwise difficult to establish whether the movement disorder is congruous or incongruous with an organic disorder.

摘要

本文的目的是指出步态障碍的不一致性(无论是与现存的运动障碍相关,还是与任何类型的器质性步态障碍不一致)是诊断精神性运动障碍的一个有用线索。为了说明这一点,我们展示了一系列患有各种类型精神性运动障碍(静止性震颤、肌阵挛、肌张力障碍和舞蹈症)的患者病例。在所有病例中,行走模式与现存运动障碍的不一致性都是一个具有启发性的诊断线索。“不一致性”目前是精神性疾病诊断的一个主要依据。我们的病例系列强调,在难以确定运动障碍与器质性疾病是否相符的患者中,步态模式的不一致性可能是最重要的体征。

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