# Fixed Dystonia of a Limb: Amputation Could Be a Favourable Outcome

## TL;DR

A patient with severe fixed dystonia of the foot found significant relief and improved mental health after undergoing amputation, suggesting it could be a viable option in extreme cases.

## Contribution

Demonstrates that amputation may be a favorable outcome for intractable fixed dystonia with severe psychosocial impact.

## Key findings

- The patient experienced complete resolution of preoperative pain after amputation.
- Minimal phantom pain was managed without surgical intervention.
- The patient regained independence and showed improved mental health with a prosthesis.

## Abstract

Fixed dystonia of limb is a rare and complex disorder characterized by abnormal, fixed posturing of a limb, often accompanied by chronic pain. Its etiology remains controversial, with debates surrounding psychogenic versus organic origins. We present the case of a 22-year-old female with a longstanding history of left foot deformity and progressively worsening neuropathic pain, which persisted despite multiple pharmacological treatments, physiotherapy, and psychological interventions. The patient developed severe psychological distress, including suicidal ideation and a self-amputation attempt. After thorough multidisciplinary evaluation, an above-knee amputation was performed. Postoperatively, she experienced complete resolution of preoperative pain, minimal phantom pain managed conservatively, and regained full independence with a prosthesis. Her functional capacity and mental health improved significantly. This case highlights the extreme challenges of managing fixed dystonia and suggests that amputation, although controversial, may be beneficial in highly selected patients with intractable symptoms and significant psychosocial impact.