A Case of Psychogenic Movement Disorders: Dark Side of Neurology and Neuropsychiatry

Objective: Our aim was to describe a patient with psychogenic movement disorder (PMD) who presented with tremor dominant involuntary movements, as well as to emphasize the clinical features important for establishing a correct diagnosis.Case-Report: A 48-year-old man presented to our outpatient neurology clinic with gait and speech disturbance. He had jerky, tremor-like involuntary movements occurring during gait, voluntary movements and/or at rest. He was unemployed, willing to get retired as a disabled veteran. Neurological examination was normal except for involuntary movements. Psychiatric consultation revealed depressed mood, anhedonia, anxiety, irritability, impulsivity, insomnia, problems in interpersonal relations and sexual dysfunction. He was diagnosed with major depressive disorder and factitious disorder and was considered as having PMD. The involuntary movements of the patient, who benefited from risperidone treatment and supportive interviews, substantially disappeared. Discussion: Since PMDs are complex disorders, a multidisciplinary approach with cooperation of neurologist and psychiatrist is needed for proper diagnoses and treatment. (Arc-hi-ves of Neu-ropsy-chi-atry 2012; 49: 235-237)