[Paroxysmal choreoathetosis]. / Die paroxysmalen Choreoathetosen.

Paroxysmal Choreoathetosis (PC) is a rare disorder which is characterized by spells of involuntary movements of the limbs, the head and the trunk lasting from a minute to several hours. PC is classified in two main types. In Paroxysmal Dystonic Choreoathetosis (PDC) the attacks are prolonged and precipitated by alcohol, emotion or fatigue, in Paroxysmal Kinesigenic Choreoathetosis (PKC) the attacks last less than 5 minutes and are precipitated by sudden movements. Although the pathophysiology of the disorder ist still uncertain, it is supposed to be an extrapyramidal disorder. Clinical features, therapeutical and differential diagnostic aspects are discussed. There is a certain risk that the disorder is misinterpreted as psychogenic or hysterical in nature. The mostly good response to medication can help the patients avoid superimposed emotional problems.

[Risk factors of classical conversion syndrome--psychogenic seizures and paralyses--observations at a neurologic clinic with 172 patients]. / Risikofaktoren klassischer Konversionssyndrome--psychogene Anfälle und Paresen--Beobachtungen einer neurologischen Klinik bei 172 Patienten.

Classical hysterical syndromes are not seldom today, either. In report on 172 patients with psychogenic fits (55% of them) or hysterical paralysis (45%) we found females preponderant in 2/3 of the cases. The beginning of symptoms was more frequent at an adolescent stage of 15 to 25 years of age and between 45 and 55. Nearly half the cases had no profession or were unskilled workers of lower strata in society. 80% of all cases have had severe conflicts or social problems in childhood or later in life. Men demonstrated more frequently professional problems: while female patients more often had problems in relationships. Younger patients were in 12% of the cases burdened with perinatal brain damages. 25% of patients with severe conversion reactions had been operated on for gastric or duodenal ulcers. Numerous occasions for symptoms manifestation are described. Long-lasting syndromes we found especially in women and in cases of psychogenic paralysis.