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Functional movement disorders psychogenic

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https://www.readbyqxmd.com/read/27913700/clinical-decision-making-in-functional-and-hyperkinetic-movement-disorders
#1
Sandra M A van der Salm, Anne-Fleur van Rootselaar, Daniëlle C Cath, Rob J de Haan, Johannes H T M Koelman, Marina A J Tijssen
OBJECTIVE: Functional or psychogenic movement disorders (FMD) present a diagnostic challenge. To diagnose FMD, clinicians must have experience with signs typical of FMD and distinguishing features from other hyperkinetic disorders. The aim of this study was to clarify the decision-making process of expert clinicians while diagnosing FMD, myoclonus, and tics. METHODS: Thirty-nine movement disorders experts rated 60 patients using a standardized web-based survey resembling clinical practice...
December 2, 2016: Neurology
https://www.readbyqxmd.com/read/27753149/functional-dystonia-and-the-borderland-between-neurology-and-psychiatry-new-concepts
#2
Rachel Newby, Jane Alty, Peter Kempster
Mind-brain dualism has dominated historical commentary on dystonia, a dichotomous approach that has left our conceptual grasp of it stubbornly incomplete. This is particularly true of functional dystonia, most diagnostically challenging of all functional movement disorders, in which the question of inherent psychogenicity remains a focus of debate. Phenomenological signs considered in isolation lack the specificity to distinguish organic and nonorganic forms, and dystonia's variability has frustrated attempts to develop objective laboratory-supported standards...
October 18, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/27719868/factitious-disorders-and-malingering-in-relation-to-functional-neurologic-disorders
#3
C Bass, P Halligan
Interest in malingering has grown in recent years, and is reflected in the exponential increase in academic publications since 1990. Although malingering is more commonly detected in medicolegal practice, it is not an all-or-nothing presentation and moreover can vary in the extent of presentation. As a nonmedical disorder, the challenge for clinical practice remains that malingering by definition is intentional and deliberate. As such, clinical skills alone are often insufficient to detect it and we describe psychometric tests such as symptom validity tests and relevant nonmedical investigations...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719859/functional-voice-disorders-clinical-presentations-and-differential-diagnosis
#4
J Baker
In this chapter, an overview of the heterogeneous group of functional voice disorders is given, including the psychogenic voice disorder (PVD) and hyperfunctional or muscle tension voice disorder (MTVD) subgroups. Reference is made to prevalence and demographic data, with empiric evidence for psychosocial factors commonly associated with the onset and maintenance of these disorders. Clinical features that distinguish between the different presentations of PVD and MTVD are described. While there are some shared characteristics, key differences between these two subgroups indicate that PVD more closely resembles the psychogenic movement disorders and a range of other functional neurologic disorders...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719854/functional-eye-movement-disorders
#5
D Kaski, A M Bronstein
Functional (psychogenic) eye movement disorders are perhaps less established in the medical literature than other types of functional movement disorders. Patients may present with ocular symptoms (e.g., blurred vision or oscillopsia) or functional eye movements may be identified during the formal examination of the eyes in patients with other functional disorders. Convergence spasm is the most common functional eye movement disorder, but functional gaze limitation, functional eye oscillations (also termed "voluntary nystagmus"), and functional convergence paralysis may be underreported...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719847/functional-sensory-symptoms
#6
J Stone, M Vermeulen
Functional (psychogenic) sensory symptoms are those in which the patient genuinely experiences alteration or absence of normal sensation in the absence of neurologic disease. The hallmark of functional sensory symptoms is the presence of internal inconsistency revealing a pattern of symptoms governed by abnormally focused attention. In this chapter we review the history of this area, different clinical presentations, diagnosis (including sensitivity of diagnostic tests), treatment, experimental studies, and prognosis...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719846/functional-gait-disorder
#7
V S C Fung
Gait disorder is a common accompaniment of functional neurologic disorders. The diagnosis of a functional or psychogenic gait is complex. It requires a sound knowledge of the range of phenomenology observed in organic movement disorders, the ability to evaluate and diagnose nonmovement disorder neurologic symptoms and signs, but additionally knowledge of potential musculoskeletal causes of gait disturbance. A stepwise approach to the analysis of the phenomenology and separation into four (sometimes overlapping) psychogenic gait syndromes is suggested to aid diagnosis: (1) movement disorder mimics; (2) neurologic (nonmovement disorder) mimics; (3) musculoskeletal or biomechanical mimics; and (4) isolated disequilibrium or balance disorders...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719845/psychogenic-functional-parkinsonism
#8
M A Thenganatt, J Jankovic
Psychogenic parkinsonism (PP), although often quite disabling, is one of the least commonly reported subtypes of psychogenic movement disorders. There are certain features that help distinguish PP from idiopathic Parkinson's disease, such as abrupt onset, early disability, bilateral shaking and slowness, nondecremental slowness when performing repetitive movements, voluntary resistance against passive movement without cogwheel rigidity, distractibility, "give-way" weakness, stuttering speech, bizarre gait, and a variety of behavioral symptoms...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719839/neurologic-diagnostic-criteria-for-functional-neurologic-disorders
#9
C Gasca-Salas, A E Lang
The diagnosis of functional neurologic disorders can be challenging. In this chapter we review the diagnostic criteria and rating scales reported for functional/psychogenic sensorimotor disturbances, psychogenic nonepileptic seizures (PNES) and functional movement disorders (FMD). A recently published scale for sensorimotor signs has some limitations, but may help in the diagnosis, and four motor and two sensory signs have been reported as highly reliable. There is good evidence using eight specific signs for the differentiation of PNES from seizures...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27667488/-clinical-features-and-treatment-of-hashimoto-encephalopathy
#10
Yoshimitsu Maki, Hiroshi Takashima
Hashimoto encephalopathy (HE) is characterized by heterogeneous neurological symptoms. HE is diagnosed based on three criteria-the presence of antithyroid antibodies, neurological symptoms from the cerebrum and/or cerebellum, and a positive response to immunotherapy. We clinically analyzed 18 patients (3 men, 15 women; age range, 38-81years) diagnosed with HE in our hospital from May 2013 to January 2016. Eleven patients showed sensory abnormalities such as strong pain, deep muscle pain, dysesthesia, paresthesia, or neuralgia...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/27663118/transcranial-magnetic-stimulation-as-a-treatment-for-functional-psychogenic-upper-limb-weakness
#11
Laura McWhirter, Lea Ludwig, Alan Carson, Robert D McIntosh, Jon Stone
OBJECTIVE: There has been a recent resurgence of interest in physical treatments for functional motor disorders (FMD) including Transcranial Magnetic Stimulation (TMS). This pilot study aimed to test the effectiveness of a single session of motor cortex TMS as a treatment for functional upper limb weakness. METHODS: Ten subjects with a diagnosis of functional upper limb weakness were randomised to immediate (n=7) or delayed (3months) (n=3) TMS treatment. Median age was 35 (range 23-52) and median symptom duration was 2...
October 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27445247/functional-disorders-in-neurology-case-studies
#12
REVIEW
Jon Stone, Ingrid Hoeritzauer, Jeannette Gelauff, Alex Lehn, Paula Gardiner, Anne van Gils, Alan Carson
Functional, often called psychogenic, disorders are common in neurological practice. We illustrate clinical issues and highlight some recent research findings using six case studies of functional neurological disorders. We discuss dizziness as a functional disorder, describing the relatively new consensus term Persistent Posturo-Perceptual Dizziness (PPPD), axial jerking/myoclonus as a functional movement disorder, functional speech symptoms, post-concussion disorder with functional cognitive symptoms and finally advances in treatment of dissociative seizures and functional motor disorders...
August 2016: Neurologic Clinics
https://www.readbyqxmd.com/read/27430001/ultrasound-as-diagnostic-tool-for-diaphragmatic-myoclonus
#13
Vesper Fe Marie Llaneza Ramos, Elaine Considine, Barbara I Karp, Codrin Lungu, Katharine Alter, Mark Hallett
BACKGROUND: Diaphragmatic myoclonus is a rare disorder of repetitive diaphragmatic contractions, acknowledged to be a spectrum that includes psychogenic features. Electromyography has been the diagnostic tool most commonly used in the literature. METHODS: To test if we could perform a noninvasive technique to delineate the diaphragm as the source of abnormal movements and demonstrate distractibility and entrainability, we used B-mode ultrasound in a patient with diaphragmatic myoclonus...
May 2016: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/27392833/the-development-of-the-icf-vestibular-environmental-scale
#14
Susan L Whitney, Ahmad Alghadir, Alia Alghwiri, Kefah M Alshebber, Mohammed Alshehri, Joseph M Furman, Martin Mueller, Eva Grill
UNLABELLED: People with vestibular disorders report changes in symptoms based on their environment with many situations increasing their symptoms. The purpose of this paper was to utilize the International Classification of Functioning Disability and Health (ICF) from the World Health Organization (WHO) to describe common environmental triggers for dizziness in persons living with balance and vestibular disorders. A multi-centre cross-sectional study was conducted with four different centres on three different continents, including patients from the United States (Pittsburgh), Germany (Munich), Jordan (Amman) and Saudi Arabia (Riyadh)...
July 2, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27172667/-updated-relationship-between-sleep-and-erectile-function
#15
Fan-bo Zhang, Rui Jiang
Penile erection (PE) is a physiological phenomenon involving complex mechanisms. PE may occur as reactive erections, psychogenic erections in the conscious state and spontaneous erections during the sleep. Sleep-related PE refers to the erections occurring spontaneously during the sleep with rapid eye movement. Studies have shown a correlation between sleep and PE as well as between sleep disorders and erectile dysfunction but not yet revealed the exact mechanisms. This paper updates the relationship between sleep and erectile function...
March 2016: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/26879346/validation-of-laboratory-supported-criteria-for-functional-psychogenic-tremor
#16
Petra Schwingenschuh, Tabish A Saifee, Petra Katschnig-Winter, Antonella Macerollo, Mariella Koegl-Wallner, Valeriu Culea, Christine Ghadery, Edith Hofer, Tamara Pendl, Stephan Seiler, Ulrike Werner, Sebastian Franthal, Natasha M Maurits, Marina A Tijssen, Reinhold Schmidt, John C Rothwell, Kailash P Bhatia, Mark J Edwards
BACKGROUND: In a small group of patients, we have previously shown that a combination of electrophysiological tests was able to distinguish functional (psychogenic) tremor and organic tremor with excellent sensitivity and specificity. OBJECTIVES: This study aims to validate an electrophysiological test battery as a tool to diagnose patients with functional tremor with a "laboratory-supported" level of certainty. METHODS: For this prospective data collection study, we recruited 38 new patients with functional tremor (mean age 37...
April 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/26877882/clinical-signs-in-functional-psychogenic-gait-disorders-a-brief-survey
#17
Leonard L Sokol, Alberto J Espay
Clinical signs are critical in ascertaining the functional nature of a gait disorder. Four signs of gait impairment have been documented in the course of examining patients with clinically definite functional (psychogenic) movement disorders: "huffing and puffing" during standing and walking, manipulation-resistance dorsiflexion of the first toe, fixed plantar flexion and inversion, and marked discrepancy between ambulation with and without swivel chair assistance. While large studies are needed to ascertain their prevalence, sensitivity, and specificity, the identification of these signs may help elevate the diagnostic certainty of functional gait disorders...
2016: J Clin Mov Disord
https://www.readbyqxmd.com/read/26863920/progression-of-nonmotor-symptoms-in-subgroups-of-patients-with-non-dopamine-deficient-parkinsonism
#18
Stuart Taylor, Joseph Gafton, Bina Shah, Gennaro Pagano, K Ray Chaudhuri, David J Brooks, Nicola Pavese
BACKGROUND: Ten to fifteen percent of Parkinson's disease (PD) patients recruited to clinical trials have scans without evidence of dopaminergic deficit, whose presence represents a heterogeneous patient population. METHODS: A cohort of 41 patients with parkinsonism and scans without evidence of dopaminergic deficit at baseline, were subdivided into groups according to their final clinical diagnoses and nigrostriatal dopamine function assessed after 2 years of study...
March 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/26581970/cranial-functional-psychogenic-movement-disorders
#19
REVIEW
Diego Kaski, Adolfo M Bronstein, Mark J Edwards, Jon Stone
Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient...
December 2015: Lancet Neurology
https://www.readbyqxmd.com/read/26365778/functional-psychogenic-movement-disorders-clinical-presentations
#20
REVIEW
Mark Hallett
Functional or psychogenic movement disorders are common and disabling, and sometime difficult to diagnose. The history and physical exam can give positive features that will support the diagnosis, which should not be based solely on exclusion. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, history of other somatic symptom and secondary gain. Anxiety and depression are common, but not necessarily more than the general population...
January 2016: Parkinsonism & related Disorders
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