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Psychogenic movement disorders
Mark Hallett1, William J Weiner, Katie Kompoliti
1Human Motor Control Section, NINDS, NIH, Bethesda, MD 20892-1428, USA. hallettm@ninds.nih.gov
Parkinsonism & Related Disorders
|December 15, 2011
Summary
Diagnosing psychogenic movement disorders requires careful observation beyond mere appearance. Key indicators include sudden onset, variability, and responsiveness to distraction, differentiating them from organic conditions.
Area of Science:
- Neurology
- Psychiatry
Background:
- Psychogenic movement disorders (PMDs) are frequently encountered but challenging to diagnose.
- Visual inspection alone is insufficient, though movement characteristics are crucial.
Purpose of the Study:
- To outline diagnostic criteria for PMDs, emphasizing positive findings.
- To detail specific features distinguishing psychogenic parkinsonism from organic forms.
Main Methods:
- Review of clinical presentation and diagnostic features of PMDs.
- Comparison of characteristic symptoms in psychogenic versus organic movement disorders.
Main Results:
- Positive diagnostic signs for PMDs include paroxysmal episodes, maximal severity at onset, variable tremor, entrainment, distractibility, and gait instability without falls.
- Psychogenic parkinsonism may present with kinetic and postural tremor, absent finger tremor, lack of sequential movement effects, extreme slowness, grunting, and absence of improved arm swing during running.
Conclusions:
- Diagnosis of PMDs relies on a constellation of specific positive findings rather than solely on bizarre appearance.
- Differentiating psychogenic parkinsonism requires attention to unique features that diverge from typical organic parkinsonism.
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