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Functional movement disorders psychogenic

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https://www.readbyqxmd.com/read/28709746/the-most-promising-advances-in-our-understanding-and-treatment-of-functional-psychogenic-movement-disorders
#1
Mark Hallett
The name functional rather than psychogenic is getting to be more widely used for terminology of this condition. It is better accepted by patients and keeps an open mind in searching for greater understanding of the pathophysiology. Advances in the pathophysiology show an overactive limbic system with connections to the motor system. Moreover, there is a disruption of the self-agency network, possibly due to a failure of feedforward signaling. There has recently been more success in treating patients. The strongest evidence is for intensive physical therapy coupled with at least some psychological support...
July 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28653211/functional-psychogenic-stereotypies
#2
José Fidel Baizabal-Carvallo, Joseph Jankovic
Functional (psychogenic) movement disorders (FMDs) may present with a broad spectrum of phenomenology including stereotypic movements. We aimed to characterize the phenomenology of functional stereotypies and compare these features with those observed in 65 patients with tardive dyskinesia (TD). From a cohort of 184 patients with FMDs, we identified 19 (10.3%) with functional stereotypies (FS). There were 15 women and 4 men, with a mean age at onset of 38.6 ± 17.4 years. Among the patients with FS, there were 9 (47%) with orolingual dyskinesia/stereotypy, 9 (47%) with limb stereotypies, 6 (32%) with trunk stereotypies, and 2 (11%) with respiratory dyskinesia as part of orofacial-laryngeal-trunk stereotypy...
July 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28638211/psychogenic-blepharospasm-a-diagnostic-dilemma
#3
Soumitra DAS, Roopchand Pandrantil Sreedharan, Prasanth Sudhakaran Remadevi, Cheruvallil Velayudhan Saji
Blepharospasm is an uncontrolled spasmodic contraction of the orbicularis muscles of the eye resulting in an abnormal tic or twitch of eyes. It usually lasts for seconds to minutes but in severe cases eyes may be closed for hours. It may be essentially benign or secondary due to a lesion in basal ganglia, pyramidal tract, and trauma, local pathology in the eyes or drug induced. Here we are presenting a case of psychogenic blepharospasm. A 65 year old woman presented with a history of episodic inability of opening her eyes for the past 6 months...
December 25, 2016: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28606495/personality-traits-in-psychogenic-nonepileptic-seizures-pnes-and-psychogenic-movement-disorder-pmd-neuroticism-and-perfectionism
#4
Vindhya Ekanayake, Sarah Kranick, Kathrin LaFaver, Arshi Naz, Anne Frank Webb, W Curt LaFrance, Mark Hallett, Valerie Voon
OBJECTIVE: Psychogenic movement disorder (PMD) and psychogenic nonepileptic seizures (PNES) are two subtypes of conversion disorder (CD). In this case-control study, we asked whether these subtypes varied as a function of personality and history of childhood abuse. METHODS: Fifty-nine patients with PMD from the Human Motor Control Section Clinic at the National Institutes of Health, 43 patients with PNES from the Rhode Island Hospital Neuropsychiatry and Behavioral Neurology Division, and 26 healthy volunteers (HC) received a battery of neurological, psychiatric and psychological assessments, including the NEO Personality Inventory Revised (NEO PI-R), the Childhood Trauma Questionnaire (CTQ), and the Traumatic Life Events Questionnaire (TLEQ)...
June 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28124436/normal-sensorimotor-plasticity-in-complex-regional-pain-syndrome-with-fixed-posture-of-the-hand
#5
Francesca Morgante, Antonino Naro, Carmen Terranova, Margherita Russo, Vincenzo Rizzo, Giovanni Risitano, Paolo Girlanda, Angelo Quartarone
BACKGROUND: Movement disorders associated with complex regional pain syndrome type I have been a subject of controversy over the last 10 years regarding their nature and pathophysiology, with an intense debate about the functional (psychogenic) nature of this disorder. The aim of this study was to test sensorimotor plasticity and cortical excitability in patients with complex regional pain syndrome type I who developed a fixed posture of the hand. METHODS: Ten patients with complex regional pain syndrome type I in the right upper limb and a fixed posture of the hand (disease duration less than 24 months) and 10 age-matched healthy subjects were enrolled...
January 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28122424/psychodynamic-psychotherapy-for-functional-psychogenic-movement-disorders
#6
Vibhash D Sharma, Randi Jones, Stewart A Factor
OBJECTIVE: As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP). METHODS: A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008-2014 at Emory University Medical Center was performed. RESULTS: Thirty patients were included, mean age at presentation was 50 years (SD 13...
January 2017: Journal of Movement Disorders
https://www.readbyqxmd.com/read/27942912/distinguishing-features-of-psychogenic-functional-versus-organic-hemifacial-spasm
#7
COMPARATIVE STUDY
José Fidel Baizabal-Carvallo, Joseph Jankovic
Hemifacial spasm (HFS) is one of the most common presentations in patients with cranial psychogenic (functional) movement disorders (PMD). Medical records and videos of patients with PMD and HFS were reviewed to identify those with psychogenic HFS and to compare the phenomenology of psychogenic HFS with organic HFS. We identified 18 (9.8%) patients with psychogenic HFS from a cohort of 184 patients with PMDs. There were 14 (78%) women and 4 men, with a mean age at onset of 33 ± 13.5 years. These were compared with 37 consecutive patients with organic (primary) HFS...
February 2017: Journal of Neurology
https://www.readbyqxmd.com/read/27913700/clinical-decision-making-in-functional-and-hyperkinetic-movement-disorders
#8
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...
January 10, 2017: Neurology
https://www.readbyqxmd.com/read/27753149/functional-dystonia-and-the-borderland-between-neurology-and-psychiatry-new-concepts
#9
REVIEW
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...
December 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
#10
REVIEW
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
#11
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719854/functional-eye-movement-disorders
#12
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719847/functional-sensory-symptoms
#13
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719846/functional-gait-disorder
#14
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719845/psychogenic-functional-parkinsonism
#15
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719839/neurologic-diagnostic-criteria-for-functional-neurologic-disorders
#16
REVIEW
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...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27667488/-clinical-features-and-treatment-of-hashimoto-encephalopathy
#17
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
#18
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
#19
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
#20
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
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