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A therapy-led, multidisciplinary programme for treatment-resistant functional fixed dystonia.

Yvonne Hsieh¹, Shaunak Deshpande²

¹Neuropsychiatry Outpatient, South London and Maudsley NHS Foundation Trust, Kent, UK yvonnehsieh1@gmail.com.

BMJ Case Reports

|July 22, 2020

Summary

Functional neurological disorder (FND) treatment improved a patient's motor symptoms and quality of life. This case study highlights a successful biopsychosocial intervention for functional fixed dystonia.

Keywords:

cognitive behavioural psychotherapy movement disorders (other than parkinsons)physiotherapy (rehabilitation)somatoform disorders

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Area of Science:

Neurology
Psychiatry
Rehabilitation

Background:

Functional neurological disorder (FND) presents unexplained neurological symptoms with a poor prognosis.
Limited research exists for clinical interventions in FND, especially for functional fixed dystonia.
A biopsychosocial model offers a framework for understanding and treating complex conditions like FND.

Observation:

A patient presented with treatment-resistant functional fixed dystonia.
The patient experienced significant limitations in daily activities and quality of life.
Conventional treatments had not yielded substantial improvements.

Findings:

A novel intervention based on a biopsychosocial model was implemented.
The intervention successfully rehabilitated the patient's functional motor symptoms.
Full range of motion was restored in the patient's right foot.
Routine outcome measurements showed significant improvement.
The patient reported the program as life-changing, enabling re-engagement in meaningful activities.

Implications:

This case demonstrates the potential efficacy of a biopsychosocial approach for functional fixed dystonia.
The findings suggest that tailored, multidisciplinary interventions can improve outcomes in FND.
Further research into biopsychosocial interventions is warranted to enhance FND treatment strategies.