Alhazmi Amal Yousef, Attar Ahmed Ahmed, Labban Suhail Ali, Felemban Reema Ghazi
Psychiatry Section, Department of Medicine, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Department of Neurology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of the National Guard-Health Affairs, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Faculty of Medical Sciences, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
Medicine (Baltimore). 2025 Jan 17;104(3):e41194. doi: 10.1097/MD.0000000000041194.
Psychogenic tremor (PT) is the most common subtype of psychogenic movement disorder, characterized by involuntary movement, and is usually related to occupational injuries or accidents. Psychogenic movement disorder falls under the category of functional neurological disorders, which are diagnosed based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders.
A 25-year-old Saudi male with a history of recurrent superior ventricular tachycardia presented to the emergency department with tremors affecting all his extremities for 8 days. Tremors were nonrhythmic, continuous, and worsened over time and were exacerbated by reaching objects. There was no history of similar presentations or neurological diseases.
Examination revealed high-frequency, high-amplitude tremors and rigidity in all extremities, and hyperreflexia in the lower limbs. Laboratory findings were unremarkable; thus, the psychiatric team was consulted for possible PTs.
Psychiatric assessments showed no evidence of psychiatric disorders. The patient only received psychoeducation about his diagnosis.
The tremor was completely resolved by the time of discharge.
In our case, the patient's PT resolved entirely with education alone, differing from previous cases that included psychotherapy and medication, emphasizing the importance of the doctor-patient relationship and the need for future research on effective approaches to delivering diagnosis to patients.
心因性震颤（PT）是心因性运动障碍最常见的亚型，其特征为不自主运动，通常与职业损伤或事故有关。心因性运动障碍属于功能性神经障碍范畴，依据《精神疾病诊断与统计手册》中概述的标准进行诊断。
一名25岁的沙特男性，有复发性室上性心动过速病史，因四肢震颤8天就诊于急诊科。震颤无节律、持续存在，且随时间加重，伸手拿东西时会加剧。既往无类似发作史及神经疾病史。
检查发现四肢有高频、高振幅震颤及强直，下肢反射亢进。实验室检查结果无异常；因此，咨询精神科团队以评估是否可能为心因性震颤。
精神科评估未发现精神障碍证据。患者仅接受了关于其诊断的心理教育。
出院时震颤完全缓解。
在我们的病例中，患者的心因性震颤仅通过教育就完全缓解，与之前包括心理治疗和药物治疗的病例不同，这强调了医患关系的重要性以及未来对向患者传达诊断的有效方法进行研究的必要性。
