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Psychogenic movement disorders.

Anette Schrag1, Anthony E Lang

  • 1Royal Free and University College Medical School, University College London, London, UK. a.schrag@medsch.ucl.ac.uk

Current Opinion in Neurology
|July 9, 2005
PubMed
Summary
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Diagnosing psychogenic movement disorders is challenging and often overlooked. Emerging clinical and laboratory findings aid in identification, particularly in post-injury cases.

Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Psychogenic movement disorders (PMDs) are frequently misdiagnosed or underdiagnosed.
  • Typical movement disorder features and even atypical ones can manifest in PMDs.
  • Psychiatric symptoms can co-occur with organic movement disorders.

Purpose of the Study:

  • To review recent studies on clinical and laboratory diagnostic features of psychogenic movement disorders.
  • To address the controversy surrounding movement disorders following peripheral injury.

Main Methods:

  • Review of current literature on diagnostic criteria for PMDs.
  • Analysis of clinical and psychiatric features associated with PMDs.
  • Evaluation of laboratory and neurophysiological investigations for differentiating PMDs from organic disorders.

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Main Results:

  • Diagnostic criteria combining clinical and psychiatric features offer diagnostic certainty for PMDs.
  • Laboratory tests (e.g., SPECT, neurophysiology) can aid in excluding organic diagnoses and identifying PMD characteristics like entrainment.
  • Some diagnostic tests lack complete specificity; psychogenic tremor may not always show perfect frequency coherence.

Conclusions:

  • Psychogenic movement disorder remains difficult to diagnose and is likely underrecognized.
  • Emerging clinical and laboratory features support PMD diagnosis.
  • A diagnosis of PMD should be actively considered in patients with movement disorders following peripheral injury.