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Psychogenic movement disorders.

Amitabh Gupta1, Anthony E Lang

  • 1Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

Current Opinion in Neurology
|June 23, 2009
PubMed
Summary
This summary is machine-generated.

Recent advancements in psychogenic movement disorders (PMDs) highlight the need for careful clinical assessment and proposed diagnostic certainty classifications. Early diagnosis and treatment are crucial for better outcomes in these complex neurological conditions.

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Area of Science:

  • Neurology
  • Neuroscience
  • Movement Disorders

Background:

  • Psychogenic movement disorders (PMDs) are complex neurological conditions requiring precise diagnosis.
  • Recent research focuses on refining diagnostic criteria and understanding underlying mechanisms.
  • The field has seen significant progress in the last two years.

Purpose of the Study:

  • To review recent advancements in psychogenic movement disorders (PMDs).
  • To propose a simplified classification of diagnostic certainty for PMDs.
  • To incorporate electrophysiological assessment into diagnostic frameworks.

Main Methods:

  • Review of recent literature on psychogenic movement disorders.
  • Analysis of functional magnetic resonance imaging (fMRI) and electrophysiological studies.
  • Evaluation of diagnostic criteria and proposed classification systems.

Main Results:

  • fMRI studies show altered blood flow in conversion disorders, suggesting synaptic activity changes.
  • Electrophysiological testing has limitations in differentiating psychogenic from organic movement disorders.
  • Evidence suggests caution in diagnosing all posttraumatic myoclonus and 'jumpy stump' as organic; psychogenic tremor is part of essential palatal tremor spectrum.
  • Gait characteristics may hold prognostic, diagnostic, or therapeutic value for PMDs.
  • Recent reviews offer insights into pediatric PMDs.

Conclusions:

  • PMD diagnosis should not be a diagnosis of exclusion; clinical assessment is paramount.
  • Imaging and electrophysiological studies aid diagnosis but challenges remain.
  • Delayed treatment often leads to poor long-term outcomes.
  • Randomized controlled trials are needed to validate and compare therapeutic options for PMDs.