r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2024-29-2-60-65r-n-j-554Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSФункциональная дистония под маской цервикальной дистонииFunctional dystonia under the guise of cervical dystoniahttps://orcid.org/0000-0002-8115-2668ТолмачеваВ. А.TolmachevaV. A.

Москва

Moscow

vtolmacheva@yandex.ruhttps://orcid.org/0009-0005-8363-5806АнгеличеваО. И.AngelichevaO. I.

Москва

Moscow

angelcheva_o_i_1@staff.sechenov.ruhttps://orcid.org/0000-0001-5904-0697ЯнакаеваТ. А.YanakaevaT. A.

Москва

Moscow

Yanakaevat@yandex.ruhttps://orcid.org/0009-0004-9696-4273БоховкоС. A.BochovkoS. A.

Москва

Moscow

boxowko@yandex.ruhttps://orcid.org/0000-0002-1822-8973РомановД. В.RomanovD. V.

Москва

Moscow

newt777@mail.ruhttps://orcid.org/0000-0002-1992-7960ПарфеновВ. А.ParfenovV. A.

Москва

Moscow

vladimirparfenov@mail.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет) Минздрава РоссииРоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет) Минздрава России; Научный центр психического здоровьяРоссияSechenov First Moscow State Medical University (Sechenov University); Federal State Budgetary Scientific Institution Mental Health Research CenterRussian Federation2024240520242926065Copyright © Толмачева В.А., Ангеличева О.И., Янакаева Т.А., Боховко С.A., Романов Д.В., Парфенов В.А., 20242024Толмачева В.А., Ангеличева О.И., Янакаева Т.А., Боховко С.A., Романов Д.В., Парфенов В.А.Tolmacheva V.A., Angelicheva O.I., Yanakaeva T.A., Bochovko S.A., Romanov D.V., Parfenov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/554

Среди функциональных неврологических расстройств (ФНР) функциональная дистония (ФД) наиболее сложна в диагностике. Представлено наблюдение пациентки 44 лет, которая длительно наблюдалась с диагнозом цервикальная дистония (ЦД) и получила инвалидность по этому заболеванию. У пациентки отсутствовали типичные проявления ЦД — повторяющиеся стереотипные движения или позы головы/шеи, сенсорный трюк, тоническое напряжение мышц шеи. В течение длительного времени возникали боли различной локализации и другие проявления ФНР. Психиатром состояние расценено как проявления шизотипического расстройства. Образовательная программа, лечебные упражнения, введение ботулинического токсина привели к уменьшению проявлений ФД. Обсуждаются вопросы патогенеза, диагноза, дифференциального диагноза и лечения ФД.

Among functional neurological disorders functional dystonia (FD) is the most difficult to diagnose. We present an observation of a 44-year-old patient, who was observed for a long time with a diagnosis of cervical dystonia (CD) and received disability for this disease. The patient did not have typical manifestations of CD — repetitive stereotypical movements or postures of the head/neck, sensory trick, tonic tension of the neck muscles. For a long time, the patient experienced pain of various localizations and other manifestations of FNR. The psychiatrist regarded the condition as symptoms of a schizotypal disorder. An educational program, therapeutic exercises, and botulinum toxin management led to a decrease in the manifestations of FD. The issues of pathogenesis, diagnosis, differential diagnosis and treatment of FD are discussed.

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