Tuesday, September 22, 2009

psychogenic dystonia

Helps if they have psychogenic tremor too.  See Fahn and Williams 1988 ADV NEUROL and Lang A Can J Neurol Sci 1995.
Features include abrupt onset, variability, bizarre extraneous movements, slow voluntary movements, resistance to passive movements, recurrence and remission, suggestibility, less distractibility.  Again, like parkinsonism, response to medication such as levodopa does not exclude psychogenic tremor.  It may be painful, exquisitely so.  Toes often are down and turned in, typical.  Big toe is usually down and in, if up it may be a striatal toe.

No comments: