Acupuncture for psychogenic movement disorders: Treatment or diagnostic tool?
Identifieur interne : 003693 ( Istex/Corpus ); précédent : 003692; suivant : 003694Acupuncture for psychogenic movement disorders: Treatment or diagnostic tool?
Auteurs : Bart F. L. Van Nuenen ; Marielle Wohlgemuth ; Rudi E. Wong Chung ; Wilson F. Abdo ; Bas R. BloemSource :
- Movement Disorders [ 0885-3185 ] ; 2007-07-15.
English descriptors
Abstract
Psychogenic movement disorders are common in everyday neurological practice, comprising up to 25% of the patient population in movement disorders clinics. The diagnosis is often difficult, as is illustrated by the high proportion of patients with an organic neurological disease whose movement disorder is misdiagnosed as psychogenic. Here, we describe a woman with a longstanding and treatment‐resistant psychogenic movement disorder that responded dramatically to acupuncture. The diagnostic and therapeutic merits of acupuncture are discussed.
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DOI: 10.1002/mds.21467
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<supportingInformation><p> This article includes supplementary video clips, available online at <url href="http://www.interscience.wiley.com/jpages/0885-3185/suppmat"> http://www.interscience.wiley.com/jpages/0885‐3185/suppmat </url>
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<caption>Baseline neurological examination demonstrated a fluent speech, with normal cognition. There were marked jerking movements of the feet and trunk (Video fragment 1). The patient was clenching her hands tightly to the arms of the wheelchair, but there were no involuntary movements involving the arms or the face. During examination of finger dexterity, when asked to stretch out the legs and also during eye closure (Video fragment 2), the involuntary movements aggravated, with considerably greater amplitudes, and wild jerking of the arms. The pattern of the movements also changed, with more or less rhythmical adduction and abduction movements of the upper leg. Upright standing was virtually impossible, and produced scissoring of the legs.Video fragment 3 shows the patient lying on an examination couch, about one hour after insertion of the acupuncture needles into both earlobes, the back and the left hand. The pattern of the involuntary movements had again changed, with now rhythmical ballistic movements of the right arm and flexion‐extension movements of the neck. This period lasted about one hour, after which the movements subacutely ‐ within a minute or so ‐ exacerbated dramatically (Video fragment 4). Once again, the pattern of the movements changed, this time into gross flinging movements of both arms and legs, almost resembling butterfly swimming. This period lasted about 1 hr, after which all involuntary movements gradually ceased. Video fragment 5 shows the full therapeutical effect, about 3 hr after initial insertion of the acupuncture needles. There were no more involuntary movements, finger dexterity was normal, but the patient had a red nose because the head had been pushed repetitively into the examination couch. Walking was still a bit careful, but otherwise almost normal.</caption>
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<affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Rudi E.</namePart>
<namePart type="family">Wong Chung</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Wilson F.</namePart>
<namePart type="family">Abdo</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Bas R.</namePart>
<namePart type="family">Bloem</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</affiliation>
<description>Correspondence: Parkinson Center Nijmegen (ParC), Department of Neurology (935), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands</description>
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<typeOfResource>text</typeOfResource>
<genre authority="originalCategForm">article</genre>
<originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<place><placeTerm type="text">Hoboken</placeTerm>
</place>
<dateIssued encoding="w3cdtf">2007-07-15</dateIssued>
<dateCaptured encoding="w3cdtf">2006-11-10</dateCaptured>
<dateValid encoding="w3cdtf">2007-02-13</dateValid>
<copyrightDate encoding="w3cdtf">2007</copyrightDate>
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<language><languageTerm type="code" authority="rfc3066">en</languageTerm>
<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract lang="en">Psychogenic movement disorders are common in everyday neurological practice, comprising up to 25% of the patient population in movement disorders clinics. The diagnosis is often difficult, as is illustrated by the high proportion of patients with an organic neurological disease whose movement disorder is misdiagnosed as psychogenic. Here, we describe a woman with a longstanding and treatment‐resistant psychogenic movement disorder that responded dramatically to acupuncture. The diagnostic and therapeutic merits of acupuncture are discussed.</abstract>
<note type="funding">NWO VIDI - No. 917.76.352; </note>
<note type="funding">Stichting International Parkinson Funds</note>
<subject lang="en"><genre>Keywords</genre>
<topic>pychogenic movement disorders</topic>
<topic>acupuncture</topic>
<topic>treatment</topic>
<topic>video case report</topic>
<topic>diagnostic tool</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Movement Disorders</title>
<subTitle>Official Journal of the Movement Disorder Society</subTitle>
</titleInfo>
<titleInfo type="abbreviated"><title>Mov. Disord.</title>
</titleInfo>
<note type="content"> This article includes supplementary video clips, available online at http://www.interscience.wiley.com/jpages/0885‐3185/suppmatSupporting Info Item: Baseline neurological examination demonstrated a fluent speech, with normal cognition. There were marked jerking movements of the feet and trunk (Video fragment 1). The patient was clenching her hands tightly to the arms of the wheelchair, but there were no involuntary movements involving the arms or the face. During examination of finger dexterity, when asked to stretch out the legs and also during eye closure (Video fragment 2), the involuntary movements aggravated, with considerably greater amplitudes, and wild jerking of the arms. The pattern of the movements also changed, with more or less rhythmical adduction and abduction movements of the upper leg. Upright standing was virtually impossible, and produced scissoring of the legs.Video fragment 3 shows the patient lying on an examination couch, about one hour after insertion of the acupuncture needles into both earlobes, the back and the left hand. The pattern of the involuntary movements had again changed, with now rhythmical ballistic movements of the right arm and flexion‐extension movements of the neck. This period lasted about one hour, after which the movements subacutely ‐ within a minute or so ‐ exacerbated dramatically (Video fragment 4). Once again, the pattern of the movements changed, this time into gross flinging movements of both arms and legs, almost resembling butterfly swimming. This period lasted about 1 hr, after which all involuntary movements gradually ceased. Video fragment 5 shows the full therapeutical effect, about 3 hr after initial insertion of the acupuncture needles. There were no more involuntary movements, finger dexterity was normal, but the patient had a red nose because the head had been pushed repetitively into the examination couch. Walking was still a bit careful, but otherwise almost normal. - </note>
<subject><genre>article category</genre>
<topic>Brief Report</topic>
</subject>
<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>2007</date>
<detail type="volume"><caption>vol.</caption>
<number>22</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>9</number>
</detail>
<extent unit="pages"><start>1353</start>
<end>1355</end>
<total>3</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">15CA3F8757C8B33051F47FEEF6C1B47C158AABD0</identifier>
<identifier type="DOI">10.1002/mds.21467</identifier>
<identifier type="ArticleID">MDS21467</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2007 Movement Disorder Society</accessCondition>
<recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin>
<recordContentSource>WILEY</recordContentSource>
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