Joos Andreas, Halmer Ramona
Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Psychotherapeutic Neurology, Kliniken Schmieder, Gailingen, Germany.
Case Rep Neurol. 2020 Jun 10;12(2):175-179. doi: 10.1159/000507567. eCollection 2020 May-Aug.
Functional tremor (FT) is a common functional neurological symptom disorder (FNSD) and difficult to treat. Diagnosis is often delayed in FNSD, which reinforces maladaptation and chronicity. The presented case, who had suffered from FT for 2 years, demonstrates the value of positive neurological symptoms in the diagnosis and treatment of FNSD, even in a chronic case. The patient improved well during integrated inpatient rehabilitation, which included mirror therapy (MT). He had complete suppressibility of the tremor during distraction, which was shown to him, and reversibility of the FT was emphasized. Due do the suppressibility when focusing on the contralateral arm, we installed MT as part of a combined inpatient neurological-psychotherapeutic rehabilitation treatment lasting 8 weeks. During treatment, some strong emotional themes came up. At the end of rehabilitation, the tremor almost completely subsided. Possible pathomechanisms are discussed. Future studies are recommended for determining the effectiveness of MT in FNSD with one-sided symptoms.
功能性震颤（FT）是一种常见的功能性神经症状障碍（FNSD），且难以治疗。在FNSD中，诊断往往会延迟，这会加剧适应不良和慢性化。本病例患者患有FT已2年，它证明了即使在慢性病例中，阳性神经症状在FNSD诊断和治疗中的价值。该患者在包括镜像疗法（MT）在内的综合住院康复期间恢复良好。当向他展示分心时震颤可完全被抑制，强调了FT的可逆性。由于专注于对侧手臂时具有抑制性，我们将MT作为为期8周的综合住院神经心理治疗康复的一部分。治疗期间出现了一些强烈的情感主题。康复结束时，震颤几乎完全消退。文中讨论了可能的发病机制。建议未来开展研究以确定MT对单侧症状的FNSD的有效性。
