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Psychogenic movement disorder

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https://www.readbyqxmd.com/read/29892195/misdiagnosed-atypical-paroxysmal-kinesigenic-dyskinesia-a-case-report
#1
Fen Pan, Shangda Li, Haimei Li, Yi Xu, Manli Huang
Background: Paroxysmal kinesigenic dyskinesia (PKD) is characterized by sudden episodes of involuntary movements. PKD is a very rare movement disorder, and correct clinical diagnosis is often a challenge. Case: We present the case of a 23-year-old female with PKD. The patient showed episodes of twisting movements for 3 years. The symptoms lasted for about 5-10 minutes and subsided spontaneously. She was diagnosed as having epilepsy, and depressive and anxiety disorders successively...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29868890/current-concepts-in-diagnosis-and-treatment-of-functional-neurological-disorders
#2
Alberto J Espay, Selma Aybek, Alan Carson, Mark J Edwards, Laura H Goldstein, Mark Hallett, Kathrin LaFaver, W Curt LaFrance, Anthony E Lang, Tim Nicholson, Glenn Nielsen, Markus Reuber, Valerie Voon, Jon Stone, Francesca Morgante
Importance: Functional neurological disorders (FND) are common sources of disability in medicine. Patients have often been misdiagnosed, correctly diagnosed after lengthy delays, and/or subjected to poorly delivered diagnoses that prevent diagnostic understanding and lead to inappropriate treatments, iatrogenic harm, unnecessary and costly evaluations, and poor outcomes. Observations: Functional Neurological Symptom Disorder/Conversion Disorder was adopted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, replacing the term psychogenic with functional and removing the criterion of psychological stress as a prerequisite for FND...
June 4, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29783067/motor-retraining-more-for-functional-movement-disorders-outcomes-from-a-one-week-multidisciplinary-rehabilitation-program
#3
Alexandra Jacob, Darryl Kaelin, Abbey Roach, Craig Ziegler, Kathrin LaFaver
BACKGROUND: Functional Movement Disorders (FMD) are conditions of abnormal motor control thought to be caused by psychological factors. These disorders are commonly seen in neurological practice and prognosis is often poor. No consensus treatment guidelines have been established, however the role of physical therapy in addition to psychotherapy has increasingly been recognized. This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies...
May 18, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29736136/a-case-of-dissociative-seizures-presented-like-myoclonic-epilepsy
#4
Balaswamy Reddy, Soumitra DAS, Mustafa Ali, Srinivas Guruprasad
Psychogenic seizures are often underdiagnosed and epilepsy is very often over-treated which leads to multiple financial, social and stigma related difficulties. The myoclonic seizure itself is a rare phenomenon and when functional movement disorder presents like myoclonus then it's extremely difficult to pinpoint the exact cause. Here, we are presenting a case who was misdiagnosed as having a myoclonic seizure disorder and treated in multiple places without any improvement which ultimately turned out to be functional movement disorder of a rare variety...
April 25, 2018: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/29736135/-the-twisted-mind-psychogenic-dystonia-in-an-adolescent-responding-to-antidepressant-therapy
#5
Seshadri Sekhar Chatterjee, Soumitra DAS, Sukanya Gupta, Sanhita Bhattacharya
Psychogenic dystonia is one of the most common problems encountered in movement disorder patients and accounted mostly for misdiagnosis, management confusion and treatment resistance. Psychiatric morbidities often are the culprit, hence proper psychiatric history taking is of utmost importance. Here we report one case where dystonia was the main presenting complaint of an underlying depressive episode and discuss how managing the cause alleviated the symptoms.
April 25, 2018: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/29735119/paroxysmal-dyskinesias
#6
Sara McGuire, Swati Chanchani, Divya S Khurana
Paroxysmal dyskinesias (PD) are hyperkinetic movement disorders where patients usually retain consciousness. Paroxysmal dyskinesias can be kinesigenic (PKD), nonkinesigenic (PNKD), and exercise induced (PED). These are usually differentiated from each other based on their phenotypic and genotypic characteristics. Genetic causes of PD are continuing to be discovered. Genes found to be involved in the pathogenesis of PD include MR-1, PRRT2, SLC2A1, and KCNMA1. The differential diagnosis is broad as PDs can mimic psychogenic events, seizure, or other movement disorders...
April 2018: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/29717363/oromandibular-dystonia-screening-questionnaire-for-differential-diagnosis
#7
Kazuya Yoshida
OBJECTIVES: Oromandibular dystonia, which is characterized by stereotypic, task-specific, or sustained contractions of masticatory and/or lingual muscles, is frequently misdiagnosed as temporomandibular disorders or psychogenic disease. Diagnostic delay in oromandibular dystonia is not acceptable; thus, a screening tool that can distinguish this condition from a temporomandibular disorder may be helpful for medical professionals unfamiliar with involuntary movements or temporomandibular disorders...
May 2, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29673578/diagnosis-of-primary-hemifacial-spasm
#8
J-P Lefaucheur, N Ben Daamer, S Sangla, C Le Guerinel
The diagnosis of primary hemifacial spasm (pHFS), due to a benign compression of the facial motor nerve by a vessel, within or close to its root exit zone, is often made with delay. Misdiagnosis includes psychogenic spasm, tics, facial myokymia or blepharospasm, but in fact post-facial palsy synkinesis (post-paralytic HFS) is the closest clinical condition, because it is limited to the territory of the facial nerve of a single hemiface. The differential diagnosis between these two entities, whose pathophysiological mechanisms are very different, can be made by electroneuromyographic (ENMG) examination...
April 16, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29571869/prevalence-of-functional-psychogenic-parkinsonism-in-two-swiss-movement-disorders-clinics-and-review-of-the-literature
#9
Giulia Frasca Polara, Vanessa Fleury, Jon Stone, Anita Barbey, Pierre R Burkhard, François Vingerhoets, Selma Aybek
BACKGROUND: Functional parkinsonism (FP) is considered rare but no studies have looked at its frequency. Case series have described high rates of comorbidity with Parkinson's disease (PD), suggesting a possible association between these conditions. OBJECTIVES: To study the prevalence, epidemiology and clinical features of FP and its association with PD. METHODS: We conducted a cross-sectional population-based prevalence study as well as a chart review of cases who received a diagnosis of FP over a 10-year-period in two movement disorder clinics in Switzerland...
April 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29519947/acute-hyperkinetic-movement-disorders-in-italian-paediatric-emergency-departments
#10
Umberto Raucci, Pasquale Parisi, Nicola Vanacore, Giacomo Garone, Claudia Bondone, Antonella Palmieri, Lucia Calistri, Agnese Suppiej, Raffaele Falsaperla, Alessandro Capuano, Valentina Ferro, Antonio Francesco Urbino, Ramona Tallone, Alessandra Montemaggi, Stefano Sartori, Piero Pavone, Margherita Mancardi, Federico Melani, Lucrezia Ilvento, Maria Federica Pelizza, Antonino Reale
INTRODUCTION: Limited data exist on epidemiology, clinical presentation and management of acute hyperkinetic movement disorders (AHMD) in paediatric emergency departments (pED). METHODS: We retrospectively analysed a case series of 256 children (aged 2 months to 17 years) presenting with AHMD to the pEDs of six Italian tertiary care hospitals over a 2-year period (January 2012 to December 2013). RESULTS: The most common type of AHMD was tics (44...
March 8, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29431985/tremor-sorting-through-the-differential-diagnosis
#11
Paul Crawford, Ethan E Zimmerman
Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients presenting to primary care physicians are enhanced physiologic tremor, essential tremor, and parkinsonian tremor. All persons have low-amplitude, high-frequency physiologic tremors at rest and during action that are not reported as symptomatic, but can be enhanced by anxiety, medication use, caffeine intake, or fatigue...
February 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29403431/acquired-sleep-related-hypermotor-epilepsy-with-disrupted-white-matter-tracts-assessed-by-multishell-diffusion-magnetic-resonance-imaging
#12
Zahari N Tchopev, Ping-Hong Yeh, Greg W Morgan, Eric Meyer, Johanna M Wolf, John M Ollinger, Gerard P Riedy, Lisa C Young
Sleep-related hypermotor epilepsy (SHE) (previously frontal lobe epilepsy) is a rare seizure disorder commonly misdiagnosed or unrecognized, causing negative patient sequelae. While usually reported in familial studies, it is more commonly acquired. Diagnosis is a challenge due to its low incidence in comparison with the more common sleep disorders or psychogenic etiologies in the differential diagnosis. Diagnosis is scaled on degree of certainty based on described or clinically documented semiology, with video EEG as a helpful, but not necessary, adjunct...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29327097/-clinical-and-cognitive-aspects-of-functional-psychogenic-tremor
#13
REVIEW
K E Zeuner, R Schmidt, P Schwingenschuh
Functional (psychogenic) tremor is the most common functional movement disorder. Characteristic clinical features, so called red flags, can help to make the clinical distinction of this type from other tremor disorders. The most common features include the variability of frequency and amplitude. Clinical examination should include different types of distraction including motor or cognitive tasks or testing the influence of suggestibility on tremor amplitude, frequency or direction. Patients often report sudden onset and remissions that may last for months or even years...
April 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29282342/-motor-symptoms-of-autoimmune-encephalopathies
#14
Yuichi Tashiro, Hiroshi Takashima
Autoimmune encephalopathies are clinically and immunologically heterogeneous disorders. At least 20 types of autoimmune encephalopathies have been discovered, with the most common type being Hashimoto encephalopathy. In clinical situations, we often observe that patients with autoimmune encephalopathy are misdiagnosed because they exhibit signs similar to those observed in functional psychogenic movement, conversion, or somatoform disorders. We clinically examined over 100 patients with autoimmune encephalopathy...
December 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29220065/clinical-profile-of-patients-with-psychogenic-non-epileptic-seizures-in-puerto-rico
#15
Joashlie M Méndez-Ruiz, Alfonso Martínez-Taboas, Yeira M Valdez-Pimentel, Miguel Torres-Narváez, Marianette Colón-Laboy, Gisela G Jiménez-Colón, José Rodríguez-Gómez, Christian J González-Jiménez
OBJECTIVE: Specialized epilepsy clinics receive many cases (20%-30% of total cases) in which the patients are diagnosed with psychogenic non-epileptic seizures (PNES). In Puerto Rico, there has been a lack of research on and data about patients with PNES. This study examined the clinical profile of 34 patients with a confirmed diagnosis of PNES. METHODS: A secondary analysis of 34 clinical records of patients with PNES was conducted. The resulting profile was based on clinical interviews, the behavioral presentation of seizures, the history of traumatic experiences or abuse, and the relationship between PNES events and life stressors...
December 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29173224/occupational-therapy-for-functional-neurological-disorders-a-scoping-review-and-agenda-for-research
#16
Paula Gardiner, Lindsey MacGregor, Alan Carson, Jon Stone
Functional neurological disorders (FND)-also called psychogenic, nonorganic, conversion, and dissociative disorders-constitute one of the commonest problems in neurological practice. An occupational therapist (OT) is commonly involved in management, but there is no specific literature or guidance for these professionals. Classification now emphasizes the importance of positive diagnosis of FND based on physical signs, more than psychological features. Studies of mechanism have produced new clinical and neurobiological ways of thinking about these disorders...
November 27, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/29143206/characteristics-of-two-distinct-clinical-phenotypes-of-functional-psychogenic-dystonia-follow-up-study
#17
Igor N Petrović, Aleksandra Tomić, Marija Mitković Vončina, Danilo Pešić, Vladimir S Kostić
BACKGROUND: The fixed dystonia phenotype was originally established as a prototype of functional dystonia. Nevertheless, in recent reports different functional dystonia phenotypes have been recognized with dystonic movement comprising phasic instead of tonic contraction. OBJECTIVES: To examine clinical characteristic in all patients with dystonia who fulfilled the criteria for functional movement disorders irrespective of phenotype in an attempt to determine parameters of clinical presentations that might impact the disease progression pattern and outcome...
January 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29124784/dysfunction-in-emotion-processing-underlies-functional-psychogenic-dystonia
#18
Alberto J Espay, Thomas Maloney, Jennifer Vannest, Matthew M Norris, James C Eliassen, Erin Neefus, Jane B Allendorfer, Robert Chen, Jerzy P Szaflarski
OBJECTIVE: We sought to determine whether abnormalities in emotion processing underlie functional (psychogenic) dystonia, one of the most common functional movement disorders. METHODS: Motor and emotion circuits were examined in 12 participants with functional dystonia, 12 with primary organic dystonia, and 25 healthy controls using functional magnetic resonance imaging at 4T and a finger-tapping task (motor task), a basic emotion-recognition task (emotional faces task), and an intense-emotion stimuli task...
January 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29055272/engaging-psychiatrists-in-the-diagnosis-of-psychogenic-nonepileptic-seizures-what-can-they-contribute
#19
Massimiliano Beghi, Giuseppe Erba, Cesare Maria Cornaggia, Giorgia Giussani, Elisa Bianchi, Gianni Porro, Michela Russo, Ettore Beghi
PURPOSE: To investigate if psychiatrists could predict the diagnosis of psychogenic nonepileptic seizures (PNES) by reviewing videos of seizures of various types and to compare the accuracy and the criteria leading to the diagnosis used by psychiatrists with those used by epileptologists. METHODS: Four board-certified psychiatrists were asked to review 23 videos capturing representative events of 21 unselected consecutive patients admitted to an epilepsy center for long-term video-EEG monitoring...
October 16, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28944096/sensory-motor-and-intrinsic-mechanisms-of-thalamic-activity-related-to-organic-and-psychogenic-dystonia
#20
K Kobayashi, J H Chien, J H Kim, F A Lenz
The thalamus is a critical module in the circuit which has been associated with movement disorders including dystonia. This circuit extends from cortex to striatum to pallidum to the thalamic nucleus Ventral Lateral anterior (VLa) to cortex and can be studied by activity recorded during thalamic stereotactic surgery for the treatment of dystonia. Neuronal recordings in the VLa nucleus show low frequency modulation of firing that is correlated with and leads the low frequency modulation of EMG activity; this EMG activity is characteristic of dystonia...
June 2017: Journal of Alzheimer's Disease and Parkinsonism
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