Dissociative facial and extra-facial motor disorder in the background of COVID-19

Authors

Mithun S. Acharya, Department of Psychiatry, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India – 574146Follow
Prathvi Kalathur, Department of Psychiatry, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India – 574146

Abstract

Dissociative facial motor disorder/Psychogenic Facial Movement Disorder (PFMD) with extra facial features is a unique presentation. A middle-aged female working as a community health worker; presented with a 5 day acute onset illness, fluctuating in severity of unilateral left facial deficits with left eyelid closure, deviation of mouth to the right side and slurring of speech. However, her emotional facial expressions, swallowing, and cough reflex were intact. Associated ipsilateral upper and lower limb motor weakness and ataxic gait were present. Clinical examination, neuro-imaging, laboratory investigations ruled out medically explainable differentials for this presentation. Psychiatric evaluation revealed 2 years history of dysthymia with dissociative stupor and currently dissociative facial with extra-facial motor disorders in the background of COVID-19. Psycho education about illness, behavioural management of primary gains, Rational Emotive Behavioural Therapy (REBT), and dealing with myths/facts of COVID-19 formed the cornerstones of management. Health care workers are in need of psychological help particularly during this COVID-19 pandemic.

Recommended Citation

Acharya, Mithun S. and Kalathur, Prathvi (2024) "Dissociative facial and extra-facial motor disorder in the background of COVID-19," Manipal Journal of Medical Sciences: Vol. 9: Iss. 1, Article 4.
DOI: https://doi.org/10.55889/2582-5984.1169
Available at: https://impressions.manipal.edu/mjms/vol9/iss1/4