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Functional neurological disorder treated with psychoeducation: A case report
Amal Yousef Alhazmi1, Ahmed Ahmed Attar2, Suhail Ali Labban3
1Psychiatry Section, Department of Medicine, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Rationale:
Psychogenic tremor (PT) is the most common subtype of psychogenic movement disorder, characterized by involuntary movement, and is usually related to occupational injuries or accidents. Psychogenic movement disorder falls under the category of functional neurological disorders, which are diagnosed based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders.
Patient Concerns:
A 25-year-old Saudi male with a history of recurrent superior ventricular tachycardia presented to the emergency department with tremors affecting all his extremities for 8 days. Tremors were nonrhythmic, continuous, and worsened over time and were exacerbated by reaching objects. There was no history of similar presentations or neurological diseases.
Diagnoses:
Examination revealed high-frequency, high-amplitude tremors and rigidity in all extremities, and hyperreflexia in the lower limbs. Laboratory findings were unremarkable; thus, the psychiatric team was consulted for possible PTs.
Interventions:
Psychiatric assessments showed no evidence of psychiatric disorders. The patient only received psychoeducation about his diagnosis.
Outcomes:
The tremor was completely resolved by the time of discharge.
Lessons:
In our case, the patient's PT resolved entirely with education alone, differing from previous cases that included psychotherapy and medication, emphasizing the importance of the doctor-patient relationship and the need for future research on effective approaches to delivering diagnosis to patients.
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