A video review of the diagnosis of psychogenic gait: appendix and commentary.
Identifieur interne : 004101 ( PubMed/Curation ); précédent : 004100; suivant : 004102A video review of the diagnosis of psychogenic gait: appendix and commentary.
Auteurs : M W Hayes [Australie] ; S. Graham ; P. Heldorf ; G. De Moore ; J G MorrisSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1999.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Conversion Disorder (diagnosis), Conversion Disorder (psychology), Diagnosis, Differential, Female, Gait, Humans, Male, Middle Aged, Movement Disorders (diagnosis), Movement Disorders (psychology), Neurologic Examination, Psychophysiologic Disorders (diagnosis), Psychophysiologic Disorders (psychology), Video Recording.
- MESH :
- diagnosis : Conversion Disorder, Movement Disorders, Psychophysiologic Disorders.
- psychology : Conversion Disorder, Movement Disorders, Psychophysiologic Disorders.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Diagnosis, Differential, Female, Gait, Humans, Male, Middle Aged, Neurologic Examination, Video Recording.
Abstract
The gait and other clinical features of 22 patients presenting to our hospital over the last 10 years are shown on video. In 12 patients, a diagnosis of psychogenic gait was made; in the remainder, the gait abnormality was the result of a neurologic disease. Psychogenic gaits are compared and contrasted with "organic" gaits. In one patient, the psychogenic gait occurred in the setting of a neurologic disease. The "traditional" approach to psychogenic gait, attempting to exclude underlying neurologic and psychiatric disease and seeking evidence for primary and secondary gain, was found to be of limited value. More useful were the features of the gait itself, in particular, exaggerated effort, extreme slowness, variability throughout the day, unusual or uneconomic postures, collapses, convulsive tremors, and distractibility; certain aspects of the history were also helpful. A list of comments is provided. The diagnosis of psychogenic gait, particularly in the elderly, remains fraught with hazard, and a balance has to be sought between subjecting an anxious patient to needless investigations and yet not losing sight of the fact that the patient may be elaborating on symptoms of genuine disease. The bizarre gait of some neurologic disorders, particularly dystonia and chorea, may be a pitfall for the unwary.
PubMed: 10584664
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In 12 patients, a diagnosis of psychogenic gait was made; in the remainder, the gait abnormality was the result of a neurologic disease. Psychogenic gaits are compared and contrasted with "organic" gaits. In one patient, the psychogenic gait occurred in the setting of a neurologic disease. The "traditional" approach to psychogenic gait, attempting to exclude underlying neurologic and psychiatric disease and seeking evidence for primary and secondary gain, was found to be of limited value. More useful were the features of the gait itself, in particular, exaggerated effort, extreme slowness, variability throughout the day, unusual or uneconomic postures, collapses, convulsive tremors, and distractibility; certain aspects of the history were also helpful. A list of comments is provided. The diagnosis of psychogenic gait, particularly in the elderly, remains fraught with hazard, and a balance has to be sought between subjecting an anxious patient to needless investigations and yet not losing sight of the fact that the patient may be elaborating on symptoms of genuine disease. The bizarre gait of some neurologic disorders, particularly dystonia and chorea, may be a pitfall for the unwary.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">10584664</PMID><DateCreated><Year>2000</Year><Month>01</Month><Day>20</Day></DateCreated><DateCompleted><Year>2000</Year><Month>01</Month><Day>20</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>14</Volume><Issue>6</Issue><PubDate><Year>1999</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>A video review of the diagnosis of psychogenic gait: appendix and commentary.</ArticleTitle><Pagination><MedlinePgn>914-21</MedlinePgn></Pagination><Abstract><AbstractText>The gait and other clinical features of 22 patients presenting to our hospital over the last 10 years are shown on video. In 12 patients, a diagnosis of psychogenic gait was made; in the remainder, the gait abnormality was the result of a neurologic disease. Psychogenic gaits are compared and contrasted with "organic" gaits. In one patient, the psychogenic gait occurred in the setting of a neurologic disease. The "traditional" approach to psychogenic gait, attempting to exclude underlying neurologic and psychiatric disease and seeking evidence for primary and secondary gain, was found to be of limited value. More useful were the features of the gait itself, in particular, exaggerated effort, extreme slowness, variability throughout the day, unusual or uneconomic postures, collapses, convulsive tremors, and distractibility; certain aspects of the history were also helpful. A list of comments is provided. The diagnosis of psychogenic gait, particularly in the elderly, remains fraught with hazard, and a balance has to be sought between subjecting an anxious patient to needless investigations and yet not losing sight of the fact that the patient may be elaborating on symptoms of genuine disease. 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