nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2022-1-115-121nnp-1760Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯFunctional writer's cramp as psychogenic focal dystoniaФункциональный писчий спазм как психогенная фокальная дистонияhttps://orcid.org/0000-0002-8115-2668ТолмачеваВ. А.TolmachevaV. A.

кафедра нервных болезней и нейрохирургии,

119021, Москва, ул. Россолимо, 11, стр.1

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Build. 1, Moscow 119021

vtolmacheva@yandex.ruhttps://orcid.org/0000-0002-7441-5546ЮзбашянП. Г.YuzbashyanP. G.

кафедра психиатрии и психосоматики Института клинической медицины им. Н.В. Склифосовского,

115522, Москва, Каширское шоссе, 34

Department of Psychiatry and Psychosomatics, N.V. Sklifosovsky Institute of Clinical Medicine, 

34, Kashirskoe Shosse, 115522 Moscow

https://orcid.org/0000-0001-6474-5245ШишоринР. М.ShishorinR. M.

кафедра психиатрии и психосоматики Института клинической медицины им. Н.В. Склифосовского,

115522, Москва, Каширское шоссе, 34

34, Kashirskoe Shosse, 115522 Moscow

https://orcid.org/0000-0003-1667-5355ВолельБ. А.VolelB. A.

кафедра психиатрии и психосоматики Института клинической медицины им. Н.В. Склифосовского,

115522, Москва, Каширское шоссе, 34

34, Kashirskoe Shosse, 115522 Moscow

https://orcid.org/0000-0002-1822-8973РомановД. В.RomanovD. V.

кафедра психиатрии и психосоматики Института клинической медицины им. Н.В. Склифосовского, 

115522, Москва, Каширское шоссе, 34

34, Kashirskoe Shosse, 115522 Moscow

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет); ФГБНУ «Научный центр психического здоровья»РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; Mental Health Research CenterRussian Federation202226022022141115121Copyright © Tolmacheva V.A., Yuzbashyan P.G., Shishorin R.M., Volel B.A., Romanov D.V., 20222022Толмачева В.А., Юзбашян П.Г., Шишорин Р.М., Волель Б.А., Романов Д.В.Tolmacheva V.A., Yuzbashyan P.G., Shishorin R.M., Volel B.A., Romanov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1760

We present a description of a functional writer's cramp case. The disease manifested as pain and tension in the right hand when writing; thus, we suspected kinesigenic dystonia in the form of writer's cramp. However, the motor pattern and the presence of additional manifestations made it possible to assume the neurotic nature of hyperkinesis. A psychiatrist diagnosed a combined conversion motor and undifferentiated somatoform disorder as a part of personality dynamics of the dramatic cluster at the involutionary age. Treatment included cognitive-behavioral therapy and periciazine administration with a positive effect. We discuss the aspects of hyperkinesis and mental status, which help differentiate the kinesigenic form of dystonia (writer's cramp) and functional movement disorder. 

Представлено описание клинического случая функционального писчего спазма. Заболевание проявлялось в виде болезненности и напряжения в правой кисти при письме, в связи с чем предполагалась кинезиогенная дистония по типу писчего спазма. Однако характер двигательного рисунка, а также имеющиеся дополнительные проявления позволили предположить невротическую природу гиперкинеза. Психиатром установлено сочетанное конверсионное двигательное и недифференцированное соматоформное расстройство в рамах динамики личности драматического кластера в инволюционном возрасте. Была проведена когнитивно-поведенческая терапия, использовался перициазин с положительным эффектом. Обсуждаются особенности собственно гиперкинеза и психического статуса, позволяющие дифференцировать кинезиогенную форму дистонии (писчий спазм) и функциональное двигательное расстройство. 

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The authors declare that there are no conflicts of interest present.