Functional dystonia under the guise of cervical dystonia

Abstract

Among functional neurological disorders functional dystonia (FD) is the most difficult to diagnose. We present an observation of a 44-year-old patient, who was observed for a long time with a diagnosis of cervical dystonia (CD) and received disability for this disease. The patient did not have typical manifestations of CD — repetitive stereotypical movements or postures of the head/neck, sensory trick, tonic tension of the neck muscles. For a long time, the patient experienced pain of various localizations and other manifestations of FNR. The psychiatrist regarded the condition as symptoms of a schizotypal disorder. An educational program, therapeutic exercises, and botulinum toxin management led to a decrease in the manifestations of FD. The issues of pathogenesis, diagnosis, differential diagnosis and treatment of FD are discussed.