Pediatric DYT-TOR1A dystonia presenting as functional neurological disorder: A case report

Functional neurological disorders are neurologic symptoms without a structural basis but can be difficult to distinguish from symptoms caused by structural brain differences (organic neurologic disorders). We present a pediatric patient who was diagnosed with functional neurological disorder and determined years later to also have an organic movement disorder, DYT-TOR1A. She was treated with deep brain stimulation with very good response. Historical features and exam findings are helpful in distinguishing functional neurological disorder from an organic movement disorder, and gauging response to treatment and clinical features over time help physicians ensure diagnostic accuracy. However, the diagnostic process is particularly challenging when functional neurological disorder and organic dystonia are present in the same patient.