Objective: To study the dystonic symptoms in patients with mild traumatic brain injury (mTBI) and whiplash injuries with or without compensation claims.
Background: Dystonia may develop after central or peripheral trauma. Central post-traumatic dystonia following traumatic brain injury (TBI) is rare, and it has been debated whether peripheral trauma, such as whiplash injuries of the neck, can in general lead to dystonia. Interestingly, many patients with post-traumatic dystonia have been involved in legal proceedings. Currently, there are no published patient series on post-traumatic paroxysmal dystonia.
Method: We evaluated post-traumatic dystonia in patients from a group of nearly 200 individuals who were reported to have suffered from mild traumatic brain injury (mTBI) and whiplash injuries, all of whom had compensation claims related to insurance-covered accidents.
Results: Patients suffering from various types of dystonic jerks were identified. These symptoms developed after a significant delay following the primary event. In some cases, they resembled psychogenic nonepileptic seizures. The dystonic symptoms did not manifest as constant dystonic postures but rather as paroxysmal dystonic attacks. None of the patients had post-traumatic pathological findings on cervical or brain MRI. In some patients, the etiology was attributed to craniocervical instability despite negative imaging findings. Analysis of a control group consisting of mTBI and whiplash patients without compensation claims revealed no cases of similar dystonic symptoms.
Conclusion: The most significant comorbidity of dystonia is psychiatric disease. Patients with pre-traumatic psychiatric symptoms may be more prone to developing functional neurological symptoms than those without psychiatric history. The observed association between dystonia and compensation claims suggests that legal proceedings may contribute to the manifestation of these symptoms. Such patients may unconsciously amplify their symptoms, including movement disorders, to the extent of becoming wheelchair-bound. These symptoms are likely to resolve once the legal processes have been concluded.
To cite this abstract in AMA style:
H. Peltonen, R. Ortiz, J. Honkaniemi. Paroxysmal Post-Traumatic Dystonia in Patients with Whiplash and Mild Traumatic Brain Injuries [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/paroxysmal-post-traumatic-dystonia-in-patients-with-whiplash-and-mild-traumatic-brain-injuries/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/paroxysmal-post-traumatic-dystonia-in-patients-with-whiplash-and-mild-traumatic-brain-injuries/