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Psychogenic movement disorders: past developments, current status, and future directions.

Anthony E Lang¹, Valerie Voon

¹Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. lang@uhnres.utoronto.ca

Movement Disorders : Official Journal of the Movement Disorder Society

|June 1, 2011

Summary

Psychogenic movement disorders are increasingly recognized and challenging to diagnose, often requiring positive diagnostic features and electrophysiological studies. These disorders cause significant disability, highlighting the urgent need for better understanding and effective treatments.

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Area of Science:

Neurology
Neuroscience
Psychiatry

Background:

Psychogenic movement disorders (PMDs) are increasingly diagnosed in subspecialty clinics.
Their recognition has grown significantly over the past 25 years.
Accurate diagnosis remains a challenge.

Observation:

Diagnosis should rely on positive findings, not solely exclusion.
Clinical presentations vary, but certain abnormal movements are more common.
Electrophysiological studies are valuable, especially for tremor and myoclonus.

Findings:

A "laboratory-supported definite" diagnostic category could enhance classification.
Diagnosing psychogenic dystonia is difficult, though cortical plasticity research shows promise.
Pathogenesis is unclear, but insights may come from studying conversion disorders.

Implications:

PMDs cause substantial disability and impair quality of life, comparable to organic movement disorders.
Treatment is challenging, often leading to chronic disability.
Further research into pathogenesis and therapies is crucial due to the profound personal and societal impact.