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A case of a psychogenic “jumpy stump”
  1. C Zadikoff1,
  2. A Mailis-Gagnon2,
  3. A E Lang3
  1. 1Movement Disorders Centre, Toronto Western Hospital, Toronto, Canada
  2. 2Comprehensive Pain Program, Toronto Western Hospital
  3. 3Movement Disorders Centre, Toronto Western Hospital
  1. Correspondence to:
 Dr A E Lang
 Morton and Gloria Shulman Movement Disorders Center, Toronto Western Hospital, McL-7, 399 Bathurst St, Toronto, ON, Canada M5T 2S8; lang{at}uhnres.utoronto.ca

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Movement disorders developing in the stump after limb amputation are well described.1 These movements are varied, consisting of jerking, tremulousness or spasms of the stump, and are often associated with severe stump pain.1 The so-called “jumpy stump” is used as one example to support the concept that peripheral injury can induce movement disorders.2 In our experience, the widespread acceptance of this concept, with little direct scientific evidence to support it, often results in the uncritical application of a diagnosis of a peripheral trauma-induced movement disorder without a careful analysis of other diagnostic possibilities, including that of a psychogenic movement disorder. To further emphasise this possibility, we report a case of a psychogenic jumpy stump.

Case report

A 42-year-old man was assessed for management of pain and painful involuntary movements of his left stump, which developed after a below-knee amputation in 1995. The patient had previously undergone nine surgical procedures to correct bone exostosis of the left foot, in the hope of achieving pain relief. One and a half years after the below-knee amputation, he developed severe stump pain. A few years later, intermittent episodes of violent jerking movements of the left stump began, which progressed to 18–20 spells a day. These could occur at rest or with voluntary movement, and could be triggered and improved …

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