Functional dystonia: A pitfall for the foot and ankle surgeon
Autor: | Dishan Singh |
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Rok vydání: | 2022 |
Předmět: |
Surgeons
Dystonia medicine.medical_specialty Movement Disorders medicine.diagnostic_test business.industry Physical examination medicine.disease Distress Physical medicine and rehabilitation medicine.anatomical_structure Deformity Humans Medicine Psychogenic disease Female Orthopedics and Sports Medicine Abnormal posturing Ankle medicine.symptom business Ankle Joint Foot (unit) |
Zdroj: | Foot and Ankle Surgery. 28:691-696 |
ISSN: | 1268-7731 |
Popis: | Functional dystonia represents a condition where psychological distress is being expressed as involuntary muscle contractions. In the foot and ankle, it most commonly presents as a sudden onset of a painful fixed ankle/hindfoot deformity in a female patient with a history of trivial trauma or surgery. The “fixed deformity” found on clinical examination is usually correctable under general anesthesia. Less commonly, it can present in the toes or may present as paroxysmal muscle movements rather than a fixed deformity. CRPS may occur concurrently with the dystonia. Failure to consider the diagnosis leads to a long delay in appropriate diagnosis, patient distress and unnecessary or even harmful surgery. A better approach to this clinical syndrome is to define it as fixed abnormal posturing that is most commonly psychogenic. Early referral to a movement disorder clinic is recommended. The prognosis is generally poor as less than a quarter of patients report subjective long-term improvement even when managed in a movement disorder clinic. Foot and ankle surgeons should, whenever possible, avoid operating on patients with functional dystonia in order to avoid symptomatic deterioration. |
Databáze: | OpenAIRE |
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