Psychogenic dystonia in children is rare and often difficult to distinguish from organic dystonia. It is usually related to a psychological or psychiatric underlying cause. From January 2004 to November 2009, 5 childr...Psychogenic dystonia in children is rare and often difficult to distinguish from organic dystonia. It is usually related to a psychological or psychiatric underlying cause. From January 2004 to November 2009, 5 children with psychogenic dystonia among 200 with dystonia were followed up in our department. Elements of history, physical examination, videotaping and management were analyzed. Mean age was 14.9 years, mean age of onset was 13 years and mean follow up period was 6 months. The dystonia onset was abrupt in 3 patients and progression resulted rapidly into fixed dystonia in 4 patients. Pain was observed in all patients. Paroxysmal dystonia was observed in one patient. An underlying psychiatric disorder was found in all patients. All patients improved with psychotherapy and anxiolytic or antidepressant drugs. Only one patient showed relapse after each familial conflicts. The small size of our series reflects this disorder is rare (1 case/year). Pain was a prominent feature in all patients. Children have acute onset, short duration of disease and improved under psychological therapy and drugs. Psychogenic dystonia in children is usually misdiagnosed. It is necessary to analyze clinical features and outcome of this disorder to reach a clear diagnosis and adequate management, which requires multifaceted approach, including psychological, physical and pharmacological therapies.展开更多
Neurometabolic diseases (NMD) are a frequent cause of epilepsy in children. Epilepsy is more frequently part of a complex clinical picture than a predominant symptom and may be of different types and various EEG patte...Neurometabolic diseases (NMD) are a frequent cause of epilepsy in children. Epilepsy is more frequently part of a complex clinical picture than a predominant symptom and may be of different types and various EEG patterns. The primary goal of this article is, departing from a large personal series, to describe the seizure type, EEG patterns and response to antiepileptic drugs in NMD and to discuss clinical value of epilepsy type in the setting of specific NMD. We found epilepsy was associated to NMD in 43.1%. Disorders of energy metabolism were the most frequent cause of epilepsy (61.3%). We observed generalized epilepsy in 75% of the patients with partial epilepsy in 25%. EEG was abnormal in only 71% of cases with variable patterns. Resistance to antiepileptic drugs was observed in 75% of cases. Valproate acid was incriminated in seizure worsening in 22.7% of the patients, all of them affected by mitochondriopathies.展开更多
文摘Psychogenic dystonia in children is rare and often difficult to distinguish from organic dystonia. It is usually related to a psychological or psychiatric underlying cause. From January 2004 to November 2009, 5 children with psychogenic dystonia among 200 with dystonia were followed up in our department. Elements of history, physical examination, videotaping and management were analyzed. Mean age was 14.9 years, mean age of onset was 13 years and mean follow up period was 6 months. The dystonia onset was abrupt in 3 patients and progression resulted rapidly into fixed dystonia in 4 patients. Pain was observed in all patients. Paroxysmal dystonia was observed in one patient. An underlying psychiatric disorder was found in all patients. All patients improved with psychotherapy and anxiolytic or antidepressant drugs. Only one patient showed relapse after each familial conflicts. The small size of our series reflects this disorder is rare (1 case/year). Pain was a prominent feature in all patients. Children have acute onset, short duration of disease and improved under psychological therapy and drugs. Psychogenic dystonia in children is usually misdiagnosed. It is necessary to analyze clinical features and outcome of this disorder to reach a clear diagnosis and adequate management, which requires multifaceted approach, including psychological, physical and pharmacological therapies.
文摘Neurometabolic diseases (NMD) are a frequent cause of epilepsy in children. Epilepsy is more frequently part of a complex clinical picture than a predominant symptom and may be of different types and various EEG patterns. The primary goal of this article is, departing from a large personal series, to describe the seizure type, EEG patterns and response to antiepileptic drugs in NMD and to discuss clinical value of epilepsy type in the setting of specific NMD. We found epilepsy was associated to NMD in 43.1%. Disorders of energy metabolism were the most frequent cause of epilepsy (61.3%). We observed generalized epilepsy in 75% of the patients with partial epilepsy in 25%. EEG was abnormal in only 71% of cases with variable patterns. Resistance to antiepileptic drugs was observed in 75% of cases. Valproate acid was incriminated in seizure worsening in 22.7% of the patients, all of them affected by mitochondriopathies.
