Psychogenic movement disorders: an unusual presentation in childhood with improvement after placebo test

Psychogenic movement disorders (PMDs) are rarely reported in childhood and their clinical manifestations may be different from those of adults[1,2,3]. A diagnosis of PMDs was made in a 12-year-old girl who presented dropped head, involuntary limb movements and gait disorder (Figure A). We performed a placebo test, which resulted in marked and complete improvement of symptoms within three days (Figure B). Psychogenic dropped head, especially associated with other movement disorders, has not yet been reported in children[2,4]. Although assessment of PMDs can be complex in childhood, our case showed that assessment of clinical features combined with therapeutic intervention (placebo test) may be useful for PMDs diagnosis[1,3,5].